CONTINUING HOMOEOPATHY MEDICAL 10.

Critical thoughts on theory of miasms

EDUCATION SERVICES WOUTERS, Maarten (NTKH, 2. 1/1990)
QUARTERLY HOMOEPATHIC DIGEST 11. What is to be cured in a case?
VOL.VIII CLAUSER, Piereluigi (NTKH, 2. 1/1990)
No. 3 SEPT.’91 12. Hints on case taking
PART I CURRENT LITERATURE SANKARAN, Rajan (NTKH, 2. 1/1990)
LISTING 13. Complementary; Homoeopathy and

A list of current homoeopathic literature, Anthroposophically

subject-wise, is given below. Except for the Extended Medicine.

CCRH Quarterly Bulletin all the others are from II. MATERIA MEDICA

the British, American, German etc. journals, not 1. The blue wonder: Sepia

readily accessible to every homoeopath. Some of EBERT, J (AHZ, 235, 4/1990)

the articles may appear in Part II in later 2. Vegetative Dysregulation-Sinusitis Chronica

numbers of the Quarterly Homoeopathic GEBHARDT, K-H. (AHZ, 235, 4/1990)

DIGEST, as abstract/ summary/ condensation/ 3. Cystolithisasis- Kalium nitricum

full, etc. WALDECKER, A (ZKH, 34, 4/1990)

I. PHILOSOPHY 4. Cardispermum halicacabum- a proving with

1. How are homoeopaths concerned with AIDS? the potencies D6 and C30.

GRUDZINSKI, Th.v. (AHZ,235, 4/1990) Part II- Symptoms list of Cardiospermum

2. The Alchemist and the Goddess Halicacabum

NORLAND, Misha (The Homoeopath, 9, RESPONDER, U. (ZKH, 34, 4/1990)

1/1989) 5. Verifications and clinical symptoms

3. How to study Materia Medica (ZKH, 34, 4/ 1990)

CANDEGABE, Eugenio (The Homoeopth, 9, 6. Boraz veneta

1/1989) CASTRO, Miranda (The Homoeopath, 9, 1/198)

4. Homoeopathy and Placebo 7. Gentiana lutea: another bee sting remedy,

REILLY, David Taylor (JAIH, 83, 3/1990) WOOD, Mathew (The Homoeopath, 9,1/1989)

5. The variety of Placebo response 8. Allergic asthma- aetiological aspects in two

CHAPMAN, Edward (JAIH, 83, 3/1990) cases treated with Sepia

6. Therapeutic Intent, Suggestion and Placebo GNAIGER, Jutta (BHJ, 79, 3/1990)

SHORE, Jonathan (JAIH, 83, 3/1990) 9. The Molluscs: Murex and Sepia

7. Some elements Homoeopathy LEESER, Otto (BHJ, 79, 3/1990)

HABIL, D.R.; POPP, Fritz- Albert (BHJ, 79, 10. Hepatoprotective action of potentized

3/1990) Lycopodium clavatum

8. Psora and history SUR, R.K., SAMAJADAR, Kayal; MITRA,

LEARY, Bernard (BHJ, 79, 3/1990) Susmita; GOLE, M.K; CHAKRABARTY, B.N.

9. Vaccinations (BHJ,79, 3/1990)

ARNOS, Kathy; KRUG, Ellen (Resonance, 12, 11. The case of the held-back heart eith cold

4, 90) hands
FELDMAN, Murray (Resonance, 12, 4/1990)
12. Nux vomica SUBRAMANYAM, VR; MISHRA, N.; RAI, Y,:
ELMORE, Durr (Resonance, 12, 4/ 90) RAKSHIT, G.; PATINAIK, NM. (BHJ, 79,
13. Small remedies seminar-a report 3/90)
JOHNSTON, Linda (Resonance, 12, 4/90) 11. Liverpool annual clinical meeting in
14. The IFH Professional Course- the last of a homoeopathic medicine 1989 (BHJ, 79, 3/90)
five part series on the 1989-90 school year. 12. Family dynamics and homoeopathy
15. Rhus toxicodendron in Paralysis, MORRISON, Roger; HERRICK Nancy (NTKH,
GELDERBLOM, Wim (NTKH, 2, 1/90) 2, 1/90)
16. Graphites in Adenoids, Enlarged Tonsils, 13. Hyperparathyroidism
Blepharitis SHAPIRO, Michael (The Hahnemannian,
BROOKS,E.D. (The Hahnemannian, October, October 1990)
1990) IV. REPERTORY
III. THERAPEUTICS 1. Computer and the homoeopathic single
1. Some common and uncommon conditions symptom
DEACON, Max ( Homoeopathy, 40, 6/90) KELLER, G.v. (ZKH, 34, 4/1990)
2. Help for the pharmacist via homoeopathy 2. Analysis of rubrics of KENT’s Repertory- Part
HOLLOWAY, Desiree, Mrs, (Homoeopathy, 40, 4, Kleptomania
6/90) SCHINDLER, M. (ZKH, 34, 4/1990)
3. A comparison in mumps-two children, 3. Remedy alterations in Repertory of KENT-
remedies, same disease Part 14: Gnaphalium and Graphites
TOWLE, Daniel P. (Resonance, 12, 4/90) EPPENICH, H. (ZKH, 34, 4/ 90)
4. The case of the held-back heart with cold V. RESEARCH
hands 1. Is it possible to prove the working of
FELDMAN, Murry (Resonance, 12, 4/90) homoeopathic high potencies-a controlled
5. Treating endometriosis with homoeopathy crossever double blind study in skin disease
REICHENBERG- ULLMAN, Judyth SCHWAB, G. (AHZ, 235, 4/90)
(Resonance, 12, 4/90) 2. Scientific case documentation in
6. Methods of case analysis Homoeopathy-the concept of the
MORRISON, Roger (JAIH, 83, 3/ 90) Niedersächsischen Akademie für Homoeopathic
7. Two children remedies und Naturheilverfahren, Celle
MOSKOWITZ, Richard (JAIH, 83, 3/1990) FLORANGE, U. (AHZ, 235, 4/1990)
8. Allergic asthma-aetiological aspects in two 3. Current perspectives in homoeopathic
cases treated with Sepia. research-results of earlier researches (Part I & II)
GNAIGER, Jutta (BHJ, 79, 3/90) WALACH, H (AHZ, 235, 4 & 5/1990)
9. Homoeopathic treatment of patients with 4. The mustard gas experiences of the British
adenomas of the prostate Homoeopathic Society: 1941-42.
VOZIANOV, A.F., SIMEONOVA, N.K. (BHJ, MORRIS OWEN, Ralph; IVES, Galen
79, 3/1990) (Homoeopathy, 40, 6/90)
10. Homoeopathic treatment of filariasis –
experience in an Indian rural setting
5. A study model with initial findings using NEUSTAEDTER, Randall (Resonance, 12,
Sepia 200c given prophylactically to prevent 4/90)
anaestrus problems in the dairy cow. *************************************
MACKIE, W. L; WILLIAMSOM, A. V.; 1. JAIH: Journal of the American Institute of
CRAWFORD, W.J. and RENNIE, B. (BHJ, 79, Homoeopathy, 1500, Massachusetts Aveune,
3/90) N.W. Suite 42, Washington D.C. 20005.
6. Homoeopathy for plants-Research survey 2. Resonance: International Foundation for
ASSELDONK, Tedje van (NTKH, 2, 1/90) Homoeopathy, 2366, Eastlake Avenue, E., Suite
VI. VETERINARY 301, Seattle, Washington 98102, U.S.A.
1. Veterinary homoeopathy 3. CCRII Quarterly Bulletin: Central Council
LOCKYER, R. (Homoeopathy, 40, 6/90) for Research in Homoeopathy, B-1/16,
2. Veterinary Questions & answers Community Centre, Janakpuri, New Delhi 110
MACLEOD, G (Homoeopathy, 40, 6/90) 058.
3. Hip dysplasia in a 61/2 years old German 4. The Homoeopath: The Journal of the Society
Shepherd of Homoeopaths, 2, Artizan Road,
GEERS, Brigitte (Resonance, 12, 4/90) Northampton NN1 4HU, U.K.
VII. HISTORY 5. Homoeopathy Today: National Centre for
1. History of the Liga Medicorum Homoeopathy, 1500 Massachusetts Avenue, NW
Homoeopathica Suite 42, Washington, D.C. 20005.
Internationalis 6. Homoeopathy: The Journal of the British
ILLING, K.-H. (ZKH, 34, 4/90) Homoeopathic Association, 27A Deconshire
2. On the interpretation of HAHNEMANN’s Street, London, WIN 1RJ., U.K.
China proving 7. The Hahnemannian: Journal of the
GRUDZINSKI, Th. von (ZKH, 34, 4/90) Homoeopathic Medical Society of the State of
VIII. GENERAL Pennsylvania, C/o Guy Hoagland, M.D., 11
1. Liverpool annual clinical Meeting in Flowers Drive, Mechanicsburg, Pennysylvania,
homoeopathic medicine 1989 (BHJ, 79, 3/90) 17055, U.S.A.
2. Surrealism in Barcelona- Conference Report, 8. BHJ: The British Homoeopathic Journal,
th
45 Congress of the International Homoeopathic Royal London Homoeopathic Hospital, Great
Medical League, Barcelona, Spain, 10-13 May Ormond Street, London, WC1N 3 HR, U.K.
1990 (BHJ, 79, 3/ 90) 9. Z K H: Zeitschrift für Klassische
3. Hazy reflections from Essen-Conference Homöopathic Karl F. Haug Verlag 6900
report Heidelberg 1, Germany.
(BHJ, 79, 3/90) 10. A H Z: Allgemeine Homöopathische
4. International Press abstracts and reviews Zeitung, Karl F. Haug Verlag, 6900 Heidelberg
(BHJ, 79, 3/90) 1, Germany.
5. Homoeopathy and acupuncturists in California 11. NTKH: Netherlands Tijdschrift voor
Klassieke Homoeopathic, Uitgeverij la Riviere &
Voorhoeve Postbus 130, 8260 AC Kampen, Some may lack the ability to recognize their
Netherlands anger. Others may have suppressed their anger
so long they are afraid of what might happen if it
ever came out. They can’t assert their ego
boundaries and take care of themselves. The
material medica emphasizes the anger of

Vol.VIII No.3 SEPT.1991 Staphysagria, but this occurs only in the later
stage of the pathology.
PART II ARTICLES
You will find Staphysagria patients to be
This nice people, with a sweetness about them. You
STAPHYSAGRIA,
can easily mistake them for Pulsatilla, or
MATERIA MEDICA,
Durr ELMORE, perhaps can’t decide between Pulsatilla and
‘Similimum’, Vol.III, Phosphorous. They’re likeable, with no hard
No.4, 1990 edges. GIBSON describes “one of the cultivate

psychological picture and essence is based on gentlemen of the earth; controlling his feelings at

lectures by George VITHOULKAS1 and Roger any price, but silently brooding over his wrongs,

MORRISON, M.D.2 We are all indebted to real or imaginary”.3

VITHOULKAS for his insight and to Roger Initially in the interview they may say very

MORRISON and Bill GRAY for their little. As you encourage them they’ll open up.

transmission and commentary. My apologies for It’s not unusual for them to weep during the

any errors or misinterpretations I may have interview (Puls., Sep., Phos., Staph).They are

mad. very sensitive people – sensitive to rudeness and

Psychological Essence: griefs. Repeated griefs are an etiology for

Staphysagria (also spelled Staphisagria) is a Causticum and Staphysagria, and these two

remedy needed by many people who suffer due remedies are complementary. There is an

to suppression of their emotions. They have a innocence, a helplessness, about them. They

strong emotional nature but are easily suppressed have no resistence; they don’t resist your

– they cannot express the emotions they feel so probing. Staphysagria patients may have

strongly. Their emotions are very alive, but humility going toward timidity. It is a good

they’re weak in their assertion of them. Anger is remedy to consider in very timid people.

especially difficult for them to process and They often become prey to others with a

express. They are very sensitive to rudeness, stronger will. Others around them may bully

reprimand, contradiction, and conflict – they them, push them, force them to obey. They will

cannot bear to experience it. Their reaction is to suppress their ideas and act like others want

hold it inside, not to express their anger, They them to act. They may become like a ‘whipping

may be insulated and say nothing, but inside they boy’ to those around them. Typically the

feel devastated, humiliated and extremely upset. Staphysagria patient will lack the force to resist

This inability to express such strong emotions these external attacks. They also may have a

creates the Staphysagria pathology. strong need to be accepted by others, which

contributes to their lack of resistance.
 They can’t handle confrontations, which can
cause emotional and physical spasms, and they
will try to avoid them. They can’t tolerate
criticism. If during an argument they feel they
must say something, because they’ve been
backed down so much, they’ll get a big
aggravation after the confrontation. For hours or
days they may feel terrible, both emotionally and
physically.
When they should feel angry, they may feel
guilty instead. They may be in a relationship
where they are repeatedly abused, physically and
emotionally. often Staphysagria is a remedy to
consider fro battered women, or women
physically, emotionally, or sexually abused in
past or present relationships. They lack the
strength to stand up to their aggressor, or to leave
the relationship. This is a state of co-
dependency-they are the victims.
After taking the remedy, a Staphysagria a
patient may leave such a destructive relationship.
She finds the strength to assert herself, to break
out of past patterns that she may have been stuck
in for years. She may be a battered wife, abused
again and again, but always lacked the strength
to leave the relationship. Give Staphysagria, and
she may well leave within one month.
If involved in an argument or confrontation,
they can’t respond-they can become speechless.
They may tremble when angry. Another big
keynote is, worse from suppression of anger.
They can get physical pathology and aggravation
of all symptoms from anger. Their aggressive
element is suppressed and they get sick. It takes
very little to suppress their anger. They cannot
rebel-it’s a type of helplessness. They feel
powerless, yet they can’t or won’t help
themselves.
They’re afraid of their anger, so they must
deny it. They fear if they let out the anger they’d
hurt or kill someone. They may drink alcohol,
and act out their anger-an “angry drunk”.
Only in the final stages is the anger
externalized. This is the Staphysagria you read
about in the old material medicas. Finally they
last out – they may scream and rage as the
suppressed anger erupts. In this late stage they
may display a constant unending stream of
anger, especially toward the person with whom
they had suppressed their anger. They may be
very irritable, touchy, indignant. If angry, they
have a tendency to throw things, or they may
tremble when angry. Suppressed emotions may
come out during sleep as angry dreams or erotic
dreams. They may dream of getting angry and
throwing things.
Staphysagria patients can be artistic,
philosophical and intellectual. They are very
refined people, not coarse. A good confirmatory
symptom of Staphysagria is writing poetry.
Another characteristic is talking to
themselves while alone. They can have long
conversations with themselves about their
situations. The more the suppression of anger,
they tend to get depressed. Usually their
depression doesn’t go toward suicide, but to a
resigned sadness. They can lose interest in life –
or can’t face life. If you have a totally sweet
patient, with depression, consider Staphysagria.
Staphysagria is a remedy with ailments
from grief, disappointed love, and broken
relationships. Then they become resigned, with a
sweetness instead of bitterness. There may be a
history of many romantic griefs. (Ignatia,
Natrum muriaticum).
Staphysagria patients usually have a high
sex drive. They are sensitive, with vital, deep
feelings. Their strong emotions are held inside,
and sex is a release of that emotional energy.
Sexuality and aggression can be linked. The
aggressive element in their personality becomes
suppressed – and gets channeled into the sexual
sphere. The strong sexual energy of
Staphysagria may manifest in an abnormal way.
They are so reserved or timid they can’t easily
make contact or initiate a relationship.
Therefore, Staphysagria is a remedy of
intense sexual fantasies, especially
masturbation. They may see someone they’re
attracted to, but won’t approach the person and
make contact. Instead they’ll have romantic
fantasies. At night in bed they may fantasize
about sex with that person and masturbated.
Often you will find a history of frequent
masturbation – they may masturbate every night
in bed to fall asleep. The strong sexuality is often
important in Staphysagria cases. The strong
tendency to fantasize, masturbate, or indulge in
lascivious thoughts has been mentioned. There
may be a tendency toward sexual excesses,
nymphomania, or perversions. The genitalia are
very sensitive, and although easily aroused, may
have premature ejaculation in the male, or
anorgasmia during coition in the female. Some
patients needing Staphysagria may not
masturbate because of religious teachings.
In a relationship they may be more
interested in sexual fantasies than sex (Platina).
Masturbation in 8-9 year old children may
suggest Staphysagria. (Origanum is a remedy for
masturbation, but not so much with the
fantasies).
You also may find a history of a passive
promiscuity. They have no resistence – can’t say
no, will do it even if they don’t want to. They
may be in a sado-masochistic relationship;
they’re the masochists. Or they may be
voyeuristic – a type of passive sexual activity.
All this sexual perversion indicates Staphysagria
is a remedy of the sycoticmiasm. The main
sycotic remedies are Pulsatilla, Staphysagria
Medorhinum, Thuja, and Natrum sulphuricum.
Finally, the memory may be affected,
especially after masturbation or sexual excesses.
He may forget what he’s read – and have no
inclination for mental work. There also may be
an aggravation from mental work.
Prescribing Hints
You will usually prescribe Staphysagria on
the essence, or glimpse a part of the essence. It’s
not a remedy with an abundance of strong
general symptoms.
There is an affinity for the genitourinary
system, nervous system, glands, skin, teeth and
musculoskeletalsystem. Although not listed, it is
one of the best cholera remedies, especially
indicated if cholera is aggravated by suppressed
emotions. Ticks, convulsions, epilepsy – any
neurological condition brought on by suppressed
anger or grief suggest Staphysagria.
A child who become autistic or retarded
from slight suppression would suggest
Staphysagria. VITHOULKAS had a case where
a left-handed child was forced to us his right
hand in first grade. For three years afterward he
was intellectually retarded. When Staphysagria
was given, he quickly regained his intellectual
abilities, and so on caught up and became an
excellent student.
Sexuality is often important in Staphysagria
cases. The strong tendency to fantasize,
masturbate, or indulge in lascivious thoughts has
been mentioned. There may be a tendency
toward sexual excesses, nymphomania, or
perversions. The genitalia are very sensitive, and
although easily aroused, may have premature
ejaculation in the male, or anorgasmia during
coition in the female.
Staphysagria should be remembered for
complaints following first coitus. “Some women
suffer very acutely (in mind as well as body)
during and for some time after the first coitus. I
have seen Staphysagria 30 give unspeakable
4
relief in such cases” . Staphysagria is the first
remedy to consider for “Honeymoon Cystitis”.
Coition may be painful for women because of
the sensitivity of the genitalia. Ailments from:
Suppressed anger, anger, romantic grief,
mortification, surgical incisions, first inter-
course, coition, sexual excesses, masturbation.
Staphysagria is a remedy to remember for
bad effects after surgery. It’s a first aid remedy
following cuts with a knife or scalpel, “wounds
made by clean-cutting objects”. It is used as an
acute post-surgical remedy. It has been
successfully used for treating pain after
episiotomy, and phantom limb pains, or surgical
incisions that are very painful. Colic since
abdominal surgery suggests Staphysagria.
Staphysagria may also have complaints
following stretching of sphincters. Causes might
include sigmoidoscope exams, vaginal dilation,
first inter-course, etc.
General Symptoms
Staphysagria temperature is not useful-they
may be chilly, average or warm, although
CLARKE says they are chilly.
Weakness of the whole body, while walking,
especially the knees. Bone pains Itching.
Sensations: Growths of skin are sensitive, as
if full of nerves, but may also be painless.
Numbness, pains shooting, stitching, burning.
General bruised sensations.
Growths: Polyps, warts, condylomata,
arthritic nodes.
Neurological: Twitches and chorea.
Worse: from mental affections, anger,
romantic grief, mortification, tobacco, coition,
masturbation, sexual excesses, afternoon nap,
light touch. Worse from letting the mind dwell
on sexual objects.
Better; after breakfast, from hard pressure,
warmth.
Regional Symptoms
Head: Headache from suppresses anger.
Headaches after a grief (Ign., Nat. mur., Staph).
Head feels like a block of wood, like a ball
inside, solid, numb- especially forehead or
occiput. Headache after coition or masturbation.
Dullness of the head, and loss of memory,
especially after sexual excuesses. Alopecia after
grief (Phosphoric acid, Ign., Staph.)
Eyes: Styes on eyelids, long lasting. Styes
are a good confirmatory symptom. Indurations
may remain for months after styes. Warts or
tumors on the eyelids. Blepharitis. Eyes may
burn and feel dry, although watering.
Staphysagria may be indicated after eye surgery.
(For a blow to the eye: Amica. Aconite may be
given for the intitial shock of an eye injury. For
the eyeball itself injured-Symphytum. For inuries
in the periorbital area: Ledum or Amica.
Mouch: Weakness of the teeth. Toothache-
worse from inhaling cold air, from cold drinks,
slight touch. Toothache better by hard pressure
or biting firmly. Teeth tend to be black, soft,
decay, crumble easily. Weakness of teeth during
pregnancy. Mucous may accumulate in the
mouth. Gums may be swollen, bleeding,
retracted, tender. Apthous ulcers.
Throat: Enlarged glands, enlarged tonsils.
Stomach: Crave sweets (2), milk, bread,
tobacco. Aversion to milk (3), generally a low
thirst. Seasickness, nausea and vomiting of
pregnancy (TESTE). Excessive hungry, even
after a meal. Colic following anger, or after
drinking cold water, or from least food or drink.
Abdomen: Griping pain; colic, incarcerated
flatus;
 Rectum: Hemorrhoids painful-especially
following suppressed anger. Sensitive sores
around rectum. Proud flesh or condylomata-can’t
bear touch it’s so painful. Flatulence.
Genitourinary System; Staphysagria has an
affinity for the genitourinary system. In either
sex, stinging, burning, stitching, shooting pains
are characteristic. Condylomata of genitalia,
especially if painful. Excrescences soft, moist
and offensive, located around glans penis.
Granular vegetations in the vagina. “Painful
sensitiveness of the sexual organs, especially
when sitting.”4
Female: honeymoon cystitis. “Constant
urging to urinate in young married women.”
Women who develop cystitis every time they
have coition – or especially if after being
abstinent for a while, suggests Staphysagria.
Burning in the urethra when not urinating is a
peculiar keynote of the cystitis. Urging after
micturition, irritable bladder syndrome, urgency,
bladder prolapse, cystocele are all covered by
this remedy.
Male: Impotence, especially after sexual
excesses. Increased desire, painful erections at
night. Enlarged prostate. Postatitis, tumors of
testes, orchitis or atrophy of testes may be
complaints of Staphysagria men. With the
prostatitis a pain runs from anus along urethra.
They eventually may be aggravated after coition
or masturbation – after sexual emissions, with
cause weakness (Calc., Kali group, Sil.).
Chest: Chronic low-grade cough from
suppressed anger, suppressed emotions. A half-
hearted cough (Tub).
Back and Extremities: HAHNEMANN’s
proving of Staphysagria indicated rheumatic
symptoms, and TYLER5 has used it successfully
for patients with rheumatic complaints. Gout,
arthritic nods, low back pain (worse night and in
morning), stitching pains in joints. Right
shoulder joint my be affected, feeling dislocated.
Joints stiff, feel tired. Numbness of finger tips.
Skin: Eruptions on back of head, behind
ears, crusty lesions. An important remedy in
psoriasis, esp. psoriasis of children. Main
remedy in psoriasis following grief or
mortification. They suffer a humiliation, then get
psoriasis. The skin of Staphysagria patients
tends to be unhealthy-sores fester, wounds heal
slowly. Moist itching eruptions; eczema, herpes,
burning after scratching. There may be warts,
tumors, or Bartholins’ cysts (Sil., Staph, Thuja).
Sleep: Sleepless nights, sleepy all day. They
may masturbate several times a night to fall
asleep. A keynote: aggravation after an
aftermoon siesta (Pulsatilla, Staphysagria.).
Sleepiness after eating.
Perspiration: profuse, with odor of rotten
eggs.
Colocynth, Causticum and Thuja are
complementary with Staphysagria. after giving
Staphysagria, the patient may go to Nux vomica
as the suppressed anger externalizes.
Confirming Symptoms
Remorse after anger. Worse after any
confrontation.
Anger suppressed easily.
Can’t speak up or stand up for themselves.
Accept blame for things. Feel guilt.
Ailments after romantic griefs.
Talk to themselves. Write poetry.
Headaches frontal and occipital. Dullness of
mind with headache.
Block of wood sensation in head.
Recurrent styes, or history of styes.
Urinary infections. Honeymoon cystitis.
Condylomata
Crave tobacco.
 High sexual desire. variations at all in this respect or whether he
Masturbation (they don’t have to masturbate would reveal a modality relating to the whole
to give Staph.,). person or not, he will reveal perhaps a very
REFERENCES characteristic local symptom which would lead
1. vithoulkas, George, Unpublished “Stolen us straight to a sure remedy.
Essences”. This ranking mentioned above with regard
2. MORRISON, Roger, M.D., Lecturer, to the mental and emotional state, then the
International Foundation for Homoeopathy, general modalities and sensations applicable to
Seattle, 1985. all the regions and lastly all the local symptom
3. GIBSON, Douglas, M.D., Studies of are arranged was conceived so by KENT in
Homeopathic Materia Medica, pp. 483-486. 1897. He described these ranking not for the
Beaconsfield Publishers, Ltd., Beaconsfield, choice of the single individual patient but for the
Bucks, England. arrangement of all symptoms of all patients in an
4. CLARKE, John H., Dictionary of Practical epidemic1. Another ranking described by KENT
Materia Medica, Vol.III. in 1914 refers not for choosing the remedy for an
5. TYLER, Margaret, M.D., Homeopathic Drug individual patient but for anthropological 2
Pictures, pp. 760-767. The C.W. Daniel Co., considerations and thoughts influenced by
Ltd., 1 Church Path, Saffron Walden, Essex, SWEDENBORG indeed. Here the symptoms of
England. loves and hates, the desires and aversions, come
6. COWPERTHWAITHE, A.C., M.D., A in the first place, then those belonging to the
Textbook of Materia Medica and “Therapeutics. rational or the so-called intellect and in the third
pp. 726-730. B. Jain Publishers, New Delhi, place those belonging to the memory. “These
India. symptoms of the mental and emotional state”. he
7. KENT, J.T., M.D. Lectures on Homeopathic wrote, “must be worked out first then follow the
Materia Medica, pp.945-948. B. Jain Pub., New – geneal sensations and modalities pertaining to
Delhi, India. the whole person and then, symptom, relating to
************************************ the blood and circulatory together”.
KENT wrote in this article itself that the
STAPHYSAGRIA AND
THE RANKINGS OF THE treatment of the single individual patient was
SYMPTOMS; different,3 namely by finding out the symptoms
KELLER, G.v., which are characteristic for this single patient,
AHZ, 231, 6/1986
that is to say, the symptoms which distinguish
That the ranking of symptoms or this patient as individual, peculiar4.
“classification” as it is often called, cannot be Another ranking which KENT has expressed
fixed on any rigid scheme independent of is the value grades in the repertories. KENT
individual cases, is evident. We cannot say, imputed a misunderstanding when, in April
before listening to the patient, that his mental 1900, he wrote that those symptoms which came
and emotional state will be striking enough to up in almost all the proves are of the highest
enable us to select a medicine. We also do not at grade.5 BOENNINGHAUSEN has given the
all know whether or not he will report any right classification6. At the lowest level the
symptoms which appeared only in the prover but
not clinically verified and at the highest level
those which had been repeatedly verified by
cures in patients.
Here, it is a question of Knowing well:
When a symptom had been observed repeatedly
in many cured cases, it would soon become well
known and every physician took note of it in
respect of his own cases and published his cases
in that connection and thus further raise the
grade of that knowledge.
This ranking has only an indirect connection
for remedy selection for the individual patient.
Here for choice of the medicine it is not a
question of high or low value which should be
relevant only to the symptom itself, here it is a
question of the grade of Similarity. There cannot
be a similarity of a thing by itself but between
two things. Always it is the relationship between
a medicine and an individual patient which has
to be evaluated here.
We judge the value of a symptom first by its
grade of being rare, i.e. we compare all the
symptoms of the patient which each other and
decide which symptoms are fully and clearly
described, which symptoms are peculiar and
singular and which are usual and common and in
no way rarely observed. We now search in the
Materia Medica the remedy symptoms which
correspond with the patient’s symptoms and now
judge the grade of correspondence. As much
higher the grade of correspondence or agreement
in wording, quality of sensations and accessory
details, so much more in turn is the value of
these symptoms.
When we look into the repertories and see
that for example, under the rubric “Skin itching”
medicines are given with different value grades
in print, it is not a question of a measure of
similarity but the frequency, that is, how often
the concerned authors have observed itching of
skin in the provers and particularly in patients
cured with this medicine.
To determine the grade of similarity
between the individuals from out of the
medicines given under this rubric, we must study
the material medica, we must see how the
provers felt the symptom and formulated it and
we must compare their expressions with those of
our patient In this way we take up one symptom
after another until our object of finding a definite
medicine is obtained.
The rubric ‘Skin itching’ is very large. In
principle very medicine in this collection has
brought out a different kind of itching of skin.
We can establish a higher grade of similarity in
this only when we compare the peculiarities. A
higher grade of print does not say much about
the relative similarity between this individual
patient and a single medicine out of these and in
a medicine which has not been given higher
grade in print may lie hidden the peculiarities
agreeing exactly with the symptoms of our
patient.
We have, for our ready use, a number of
keywords in our memory which enable us to
recall the particular medicine when the patient
expresses one or more of these complaints. For
example we have the following keywords ready
in respect of Staphysagria: Onanism –Styles –
Indignation – Mortification – Pain forehead –
Skin itching – Gluttony. If a patient complains of
Styes we will look in it for other key wores well
known to us of Staphysagria. In this it is not so
essential or important whether the patient has
gluttony or itching of skin; very much important
is how the glutton, how the itching of skin are
conditioned as between the medicine and our
patient. If possible the exact words should be
compared so that the comparative grade of
similarity could be found with greater certainty.
One can often recognize Staphysagria from
the nature of the itching of skin, namely a prick
in the skin which goes from within to without
and which then when it reaches the surface itches
violently for a short time which would be am.
when scratched at that part but would
immediately appear at another part not scratched.
This itching of Staphysagria can be so exactly
described by a patient that one can with this
alone expect definite success with greater
certainty.
Similarly about the pain in forehead of
Staphysagria which symptom by itself would
closely indicate this medicine. Such a pain in the
forehead led me to prescribe correctly in a case
of an eight year old boy whose enuresis
nocturna as also certain other concomitant
ailments and behaviour disturbances were
relieved within few days by Staphysagria. He
had such a deep sleep that he did not hear the
bell ringing, a situation which made me recall
Kreosote. He further complained of headaches
and he spontaneously said that he had headache,
and was disoriented with his surroundings. His
mother said that h then “wrung his hands and
gesticulated.” That corresponded to Kreosote to
“pains cause severe physical restlessness” which
is very characteristic. Most of these pains which
cause the restlessness are localized in the lower
abdomen of women, but nevertheless the
similarity appeared to me striking.
Also the fact that the patient sucked his
thumb often and with the other hand handled his
genitals did not contraindicate kreosote and the
enuresis did not however stop. But after
administering Kreosote other symptoms came up
which ultimately led me to Staphysagria. He
could now so clearly describe his headache that
the similarity was clear. To describe the quality
of the sensation he demonstrated with his finger
to a small spot in the middle of his forehead
above the root of the nose and said in exact
words that the pain was “in the middle here”.
Those who are not familiar with the
analogus Staphysagria symptoms, will find it
difficult to find it in the KENT’s Repertory
because it is mentioned there only under the key-
word “Ball”7. All other terms which come up in
the full list of symptoms, like “round”, “heavy”,
“well-fixed”, “brain”, “behind the forehead” or
“small spots”, do not have any rubric. The
symptom in the text reads:” sensation of a heavy,
small ball which is fixed well in the brain above
the root of the nose”.
Staphysagria has, as is well known,
tendency for masturbation in high grade, the
association of Staphysagria – Onanism is well
used by every homeopath indeed as soon as he
hears these two terms. Now it is not often so
simple to enquire of patients or at all children
about such habits. But Staphysagria will not
therefore be overlooked, indeed rarely, if other
symptoms indicate it. And it was so in my case,
when I prescribed at first Kreoste to the boy.
Now at the next interview, the mother said in
answer to my question: He constantly sucks his
thumb and has his other hand on his genitals. In
bed he regularly masturbated and did not make
any secret of it. The boy himself spontaneously
said of both these acts, the bed-wetting and that
pleasant sensation and they were well connected
with each other.
That was the progress of a homeopathic
treatment. During a consultation we note the
peculiar expressions of the patient and perceive
by the way those medicines which strike us then.
We weigh out which symptom is especially
singular of the patient and we first search out for
those medicines which are related to these
symptoms. The value of such a symptom, is, on
the one side, conditioned as to how characteristic
it is for the patient and on the other side how
much more it is in correspondence with the
symptoms of the analogus medicine. A examinations are upon this plane, then it must
numerical computation is not relevant in this, a
rigid scheme diverts the physician from the
perception of the symptoms of the patient.
The perception and adoption of the patient’s
symptoms is the core of homeopathic profession.
Everything which hinders attention to what the
patient says have nothing to do including all
theories alien to practice, like the ranking of the
symptoms.
1) JHC, 1 (1897), 1, 16: “When a given
epidemic, or endemic comes upon the land, as
many cases, most carefully written out, as can be
gathered, are to be arranged in the
Hahnemannian schema, all symptoms under
regional headings, so that the prevailing disease
may be viewed collectively, as a unit, or, as the
image of a man, or as though one man had
suffered from all the symptoms observed…
Incidentally this may show the value of
HAHNEMANN’s schema. The particular or
individual study in the epidemic cannot be
properly made until the symptoms are studied
collectively, and this kind of study is the same as
after a proving has been arranged in schematic
form. Every epidemic and every mari sick must
be so wrought out; first the general and then the
particular… Great mistakes may come from
going too deeply into the particulars before the
generals are settled. An army of soldiers without
the line of officers could not be but a mob; such
a mob of confusion is our material medica to the
man who has not the command.”
2) With purpose I employ here an expression
generally used in the Anthroposophy. The
similarity of KENTian World View with the
anthroposophic is clear from another place in the
above cited article in the year 1897 (p.11): “The
abstract vital force is, to the untrained
understanding, unthinkable, and as all internal
follow that a preparatory training must preced e
he actual examination of the internal qualities of
the three kingdoms which exist in the interior of
man (animal – plant – mineral)”.
The anthroposophic medicine considers it
essential for its School of thought, “to be able to
see through the connection of Man and Nature”
(BUTTNER).
3) JHC, 1(1897), 1, 7: “The symptoms must be
judged as to their value as characteristics, in
relation to the patient; they must be passed in
review by the rational mind to determine those
which are strange, rare and peculiar. Symptoms
most peculiar to the patient must be taken first,
then those less and less peculiar until the
symptoms that are common and not peculiar are
reached, in order, from the first to last”.
4) Ibid, Page 7: “The scientific method is the
mechanical method taking all the symptoms and
writing out all the associated remedies with
gradings, making a summary with grades
marked, at the end. There is an artistic method
that omits the mechanical, and is better, but all
are not prepared to use it. The artistic method
demands that judgement be passed on all the
symptoms after the case is most carefully taken;
the symptoms must be judged as to their value
characteristics, in relation to the patient; they
must be passed in review by the rational mind to
determine those which are strange, rare and
peculiar.”
5) KENT 1957, 213: “For example take that
symptom of Apis, “suffocation in a warm
room,”; all the provers of Apis, or nearly all were
affected to a great extent in that way. All the
provers of Pulsatilla were worse in a warm
room. There can be no doubt about such
symptoms for all the provers felt that state so
strongly.”
Evidently KENT followed here the then
well-prevalent general opinion that proving
symptoms were of greater value than clinical
symptoms. This opinion came from Richard
th
HUGHES who took part in the 37 meeting of
the American Institute of Homeopathy in June
1884 in Deer Park and in June 1891 in the then 5
years old Liga Congrss in Atlantic City which
impressed American homeopathy very much.
HUGHES attempted, as it well-known, to purify
the homoeopathic material medica of all
symptoms obtained from cure of sick patients, so
that his well-known object of acceptance of
Homeopathy by the Allopathic School could be
attained.
6) BOENNINGHAUSEN 1833, XVI.
*************************************
STAPHYSAGRIA, a
medicine for active
persons,
BOTTGER, H.E.
AHZ, 228, 4/1983
Introduction: Classical homoeopathy
requires hard work and a good amount of time to
mature. Memorizing is not sufficient. In the
clinic this therapy is rewarding indeed but
unfortunately the pressure on time cannot be
ignored. It is therefore a great help to call to
mind readily the characteristics of a remedy
picture in few words, to understand the remedy
in its root and to understand it in its spirit in the
patients.
Problem of remedy picture: Such
characteristics of Staphysagria will be; Office
Executive’s medicine; Sexual Hypochondriac or
Neurasthenic, that is, passive build, men without
energy and ‘initiative’.
For the first time I came to understand
thoroughly the word “much helplessness against
emotional challenges”. Now a door opens – a
dangerous door with I came to be aware of
slowly: the helplessness does not reflect as a
symptom of the patient. And Staphysagria is not
found under this rubric in KENT. Likewise, in
rare cases patients depict their sexual
helplessness and the consequences.
How should I collect the symptoms if the
patient does not depict any?
To proceed, views are insinuated as intuition
and interpretation. These opinions are dangerous
because interpretation and intuition are not
teachable or learnable. We would be making
homoeopathy untrustworthy by our own
scientific postulates.
Case examples from my practice: Two cases
from the daily practice are cited to depict the
common negative version of Staphysagria
picture as unintelligible and substitute for it a
positive depiction.
These two cases depict Staphysagria in
positive light. Two persons are depicted here.
Because of the Psora it was impossible for them
to react to the challenges from their environment.
So they suffer. From this it will be clear that we
will have it to do with consequences of grief,
mortification, discontent and similar categories.
We must also pay much attention to discover the
symptoms of the ailments, the consequences of a
mortification discontent etc.
Case1. A 31 yr. old woman. In her appearance
not any more maidenly nor womanly. She
appeared stuck in a fairway. She is languishing
a so.
 She complained of palpitations. “We read a
lot about heart infarcts”, said she.
Her husband has taken to another woman.
And when she expresses her anger and
annoyance, he does not react, and she gets angry
thereafter for long over her own outrage – and in
that she has a bad conscience.
To my question: “That must mortify you
much?” came a spontaneous ‘yes!’
The clinical investigation did not show
anything wrong.
Therapy: From 16.2 – 5.3.81; 3 x daily 5
drops Staphysagria 6. After this she showed a
new attitude with her husband. Her thinking has
become clearer, said she with bright eyes.
Further therpy: 3 x 1 tablet Staphysagria D
30 on 5.3., 28.4 9.6., 24.7., 12.10.81.
After six months her husband again came to
her. She did not anymore need to nibble her
fingernails (she had not mentioned it before).
When she did not know something further, she
told her husband; “your must help me further,
when I do not know” or “show me again that yo
love me and take me in your arms”. Her
helplessness changed so spontaneously and
yielded to an actively positive attitude.
Case 2: A nine year old boy was brought to the
clinic by his grand mother. “Since recently he is
not “ concentrating”; he was always good in his
studies before.
I know his mother from childhood. She had
married twice and divorced twice. The boy came
out of the first marriage; be was being brought
up by the grandmother. There is therefore
actually sufficient reasons for the behavioural
disturbances. His achievements in school has
become poor only since recently.
Speaking about his teachers when we came
to talk about a particular lady teacher, his voice
became low and inaudible. “When the other
students talk about her during the recesses, I feel
like boxing them.” When I asked “you are much
attached to your teacher?” He replied: “YES”,
“And why don’t you then tell the others how
stupid they are when they speak ill of her?” “I
cannot”. A good symptom which one can obtain
so spontaneously and clearly only from a child.
Therapy: One dose of Staphysagria D 30 one
tablet twice on 7.10., 15.11., 13.12., 76, 20. 2.77,
Staphysagria D 200 18.4., 1.9., 3.11.77., 30.3.,
31.7.78.
One year’s Staphysagria course made a
good student of him.
The repetition was when his grandmother
said: “He is again so restless or he “fantasies” in
sleep or on his daily events.”
Everytime, after a dose improvement lasted
more but repetitions were warranted till 1978.
Remained well after that.
Repertorisation on KENT’s Repertory:
Which symptoms were chosen?
Case 1: 1. The woman appeared
disproportionately developed to her age; the
mental development appears hindered. That is
the consequence of a disease, not a symptom.
2. Palpitation! She has the anxiety that she
would suffer a heart infarct.
3. Anger that she cannot express her
annoyance with remains therefore unsuccessful.
These are very valuable mental symptoms
but they are not to be found exactly so in KENT.
Let me take the palpitation. It is not an
occasional happening. It must be a very restless
condition; because palpitation while taking a
break is considered as infarct. That must of
course be very violent. And Staphysagria is
given in grade 2.
And what about her anger about her
unexpressed feelings?
 That there is consequence of a mortification
we know from a reply question. It is not possible
to actively oppose, confront this mortification
from discontentment? Dissatisfied, discontent,
grade 2.
Case 2: 1. The child is not concentrating
2. Sunk tone which discloses an emotion.
3. Must box to control his emotion.
4. Inability to verbally express
annoyance.
In the first case I was guided by the
woman’s reply to my question: “that was very
mortifying to you?” and in the second case “why
don’t you then tell the other children how stupid
they are?” With this knowledge and MEZGER’s
formula of “great helplessness against emotional
challenges” I came to Staphysagria Ailments
from mortification – p.68.
But besides Staphysagria there
medicines in high grade and grade 2, not to
speak of the lower grade.
The lack of concentration was taken as the
next symptom and Staphysagria is in low grade
only. The annoyance, his inability to overcome
his emotions comes under ‘Discontented’ P. 36
Staphysagria grade 2.
The unstable voice which revealed the
emotions, hollow and hoarse; weak voice; loss of
voice after anger; Staphysagria alone. And the
last symptom: “must box his schoolmates”
indeed mean that a high degree of anger was
running in his mind and caused ailments;
Staphysagria in high grade again. So these
would be sufficient. And the successful result
validated the correctness of the choice.
My statement at the commencement of this
article that one must have at one’s command a
remedy picture in a few words is proved thus.
Practical time in the clinic is too short.
Classifying and repertorisation demand so much
of the little time.
Discussion: I have not come across the picture
of neurasthenic and sexual hypochondriac
Staphysagria. Of course in both the above cases
sexuality did play its role in the broadest sense,
i.e. the relationship adopted to the other sex. The
young woman did not feel the right relationship
his with her husband and the 9 yrs. old boy was
crazy over his lady teacher.
In both cases I do not see hypochondriacal
traits. Both were dissatisfied, unable to overcome
and suffered therefrom. Nothing of the anxious
evasiveness and gloominess observed. In the
case of the young wife the heart made its
demand by massive palpitation like in a heart
infarct: At last do something so that your
husband does not leave you! and the young boy
are rapped himself and did not passively hide
himself in (could be a possible reaction).
I am not alone in holding the view of the
negative defence of the Staphysagria picture.
von UNGERN-STERNBERG had already, in
1968 in Berlin, turned round the stereotype
traditional depiction of Staphysagria as sexual
hypochondriac and neurasthenic.
So also MEZGER’s guiding formula of
“helplessness against emotional strains”. I want
to explain further.
Let us consider the therapy result; The
young woman had developed a different attitude
toward her husband; she could now say; “You
must help me, when I cannot any more – and
show me, that you love me and take me again in
your arm.” – And the boy did not anymore need
to box and found the right attitude in his childish
fancies so that he would not be anymore teased
by his school-mates.
Where lies the similarity or commonness
between the two cases? Both did not find the
courage to transcend the hindrance threshold and is a gem. Such carious teeth cannot be depended
process the emotional demands bothering them. upon to bite. And the worst: everyone can see ti
Psora was the hindrance in the patients. And immediately. Mortification over mortification
what is worser for an active person than be with clear representation that it cannot go further
unable to be in control of his thoughts? Here it is and all effort is unsuccessful.
not helplessness anymore but it is mortifying and *************************************
that led to the sickness. We could understand
that well. And now the circle becomes complete. STAPHYSAGRIA IN
Because that is a good symptom and it requires PSYCHIATRY,
Jacqueline
no interpretation and intuition. If I take it up as
BARBANCEY, MD,
helplessness and If I were to ask woman: “Are ‘BHJ’, Vol. 79,
you then helpless against your husband?” and Janurary 1990.
The various material medicas give us several
she were to answer; “Not in anyway, I shout at
quite different images of Staphysagria, which
him or I will not allow him anymore into the
may surprise and puzzle the students and new
house.”
practitioners of homeopathy.
And then I am exactly smart. To my
Staphysagria is sometimes given as
question: “You must have felt very much
similimum with people who show a very sad
mortified?” came the spontaneous answer, a
outward appearance and the following features:
verbal and emotional concurrence. The same
surly, verminous children with prematurely
with the boy also. In KENT Staphysagria is in
decayed teeth.
high grade.
thin, sad, asthenic, impotent men.
The urinary ailments of the newly married
nymphomaniac women with irritating and foul
young women can also be understood so; we all
secretions.
know of the difficulties about the first sexual
old men with prostatism, with urinary frequency
relationship. And we also know that not all
and incontinence and weak memory.
young wives have the courage to verbally air
depressed patients with bone pains at night, with
their distress; she is having Staphysagria
chalazae, and scabby, itching, oozing dermatitis.
sickness. And the Office Executive’s medicine
and, above all, a common and characteristic
Staphysagria : all officers are not
feature: erotic obsessions, masturbation, sexual
hypochondriacs. Of course many are active
indignation which are responsible, more or less
persons. The executives in their various classes
openly, for the complaints.
have to withstand invectives and disparagements
Another image of this medicine is that of
and must bow down. Staphysagria patients then
sensitive and irritable individuals, heavy
become helpless and suffer. Healthy persons find
smokers, with a canine appetite:
an unsuppressed modus vivendi. So
irascible to such an extent that they may throw
Staphysagria is not at all a negative medicine. It
things in the face of any opponent, or throw
cannot bite in situation where it should feel to do
objects into the fire out of spite, having lost
so. Think of the bad carious in situation where it
all self-control.
should feel to do so. Think of the bad carious
prone to gastro-intestional colic after having felt
teeth – of children – which according to NASH
themselves attacked or when they believe it
 has been so – sad and apathetic after injury
to their self-respect.
with an easily upset, disturbed mind and with
such indignation that they may suffer
thought disorders or confusion, walking and
talking restlessly.
Whose psycho-sexual excitability is only
mentioned secondarily.
It is possible to integrate the first image
(which is almost exclusively given by
BOERICKE, DUPRAT, LATHOUD and a few
modern authors) with the second (found in
JAHR, KENT, HODIAMONT and in some
recent material medicas) resulting in a synthesis
which is very useful for dynamic understanding
of the patient and more accurate prescribing.
Both aspects seem to originate in the
biphasic effects of delphinine, the active alkaloid
of Staphysagria, which can be compared with
those of veratrine or curare, causing excitation
followed by a succession of depressive
symptoms.
There is therefore no contradiction in the
apparently paradoxical indications of
Staphysagria.
susceptible, irascible, hot-tempered people,
some features of whose character are reminiscent
of Lycopodium who are unable to express the
stress repressing them, but, inside are full of an
impotent rage.
depressive, apathetic people, whose memory
is failing, having obsessions of sexual nature
(either from lack of satisfaction or from painful
memories), suffering (sometimes for a long time)
from humiliations, vexations and from unhealed
moral injuries.
In both case the psychic strongly affects the
physical especially in the thorax and abdomen; it
is correct to say that Staphysagria is a typically
psychosomatic medicine and that the image
which has been given of it, for too long, as the
medicine of ‘sexual repression’ has distorted the
understanding of it and reduced its use.
A long time ago, I verified the extreme
frequency with which Staphysagria is indicated
in psychiatric pathology; not usually as a result
of any king of ‘excessive onanism’ (a far less
reliable symptom than in Rana bufo) or ‘sexual
sins’ as BOERICKE ahs it. I wonder what a new
proving of Staphysagria would produce upon the
healthy individual of 1989 with his erotic
reactions very different from those of the doctors
of 1850. I underline: ‘erotic reactions’ and not
sexual physiological reactions, that is to say,
behaviour towards sexuality and ability to
integrate impulses, or the way in which they are
repressed, the latter being particularly relevant in
this context.
It may be help in people who suffer sexual
obsessions (they still exist!) but it should now be
given much less frequently on the basis of this
traditional indication and rather on the a basis of
careful observation and attentive listening to the
patient, her complaints, ailments and the
biography which presents and expresses that
which he cannot spontaneously express: his
truth, the real cause of his state, leading to the
prescription and to dialogue, both having to be
built ‘to order’.
Even given a certain reserve with regard to
the improvement obtained (because of placebo
effects which are difficult to estimate in a private
psychiatric practice), I have been much
impressed by the quick and powerful action of
Staphysagira: not so much by the sedative and
soothing effect, at least in the beginning – but by
the disinhibiting effect upon the guiding
symptom; consequences of emotional stresses,
perceived but neither expressed nor externalized,
of which the following examples:
 A seven-year old child, having witnessed Existential situations of sexual frustration
violent scenes between his parents, not saying (celibacy, unconsummated marriage,
anything about it at the time, apparently having widowhood, religious engagement), once
taken it with indifference but having voluntarily accepted but now hard to bear; but
subsequently developed school difficulties and only when these are real cause of reactions of
character problems. character, irascibility and/ or psychosomatic
A forty-year old man, indignant at having troubles.
been rudely sacked, harbouring aggressive ideas Even better than the therapeutic
of revenge. Attending the dermatologists with observations, which may not be fully objective,
hands which have been made redundant and are we may mention the spontaneous (and
now covered with eczema. sometimes picturesque) testimony of the patients
Situation of indignation, when the patient is themselves:
unable to answer directly to any kind of Mrs. D. 37, years old, shop assistant: Oh!
vexation, injustice, contempt, humiliation or On Sunday! What a relief!
emotional rejection: It is unbelievable that medicine
Either because the circumstances do not Staphysagira ! Before I was feeling
allow him to do so (hierarchy etc.) or because the so miserable from Friday night, and on
person does not allow herself to do so, or Saturday all the enjoyment
because the frustration has been so unbearable of the weekend was spoiled just by thinking
that it has been immediately repressed in to the of me facing my boss
unconscious mind, the individual, to all again on Monday. Now, I am not afraid of
appearances, not having any memory of it. But him any more, just as
its modified trace which has been transformed I used to be afraid of my father, before, I
under what we call in psychoanalysis ‘real have understood! So that
symptoms’, which may be more or less easy to was the reason…!
identify. Mr. W. 41 years old, unemployed engineer’.
Sexual trauma: which, although not being the It is really extraordinary,
essential Staphysagira indication, is no less an What your dose has done for me. I feel that I
indication for this medicine when causing have recovered the
trouble. use of my personality, I mean my
For instance in the child: an interruption of freedom…!
the intellectual and psychological development; Mrs. B, 30 years old, housewife, wrote to
in the adolescent girl: distortion of body image, me: ‘At least, thanks to you, Doctor, and your
anorexia nervosa; pills, I have been able to tell my mother-in-law
In the adolescent boy; homosexuality, all that I wanted to tell her and, what is more, I
especially when the emotional shock has been did it peacefully, without having felt guilty nor
intense, when it has not been possible to say falling sick over it!’
anything, when a sexual constraint has been So having been led, throught personal
exerted by a parent or by an educator. experience, to appreciate better the action of
Staphysagira and having got a vision which is
somehow a little different from the unusal one, I
was very pleased to read a communication from
our German colleague, BOTTGER, presented in
th
1982 in Brighton, during the 37 Congress of the
Homeopathic League. He deplored the foregone
conclusion which has generally considered
Staphysagira as a medicine for passive,
submissive people, always matched with the
‘cliché of the besetting sexual frustratiion’. and
insisted on the value of MEZGER’s formulation:
‘Staphysagira has a relation with a great
confusion under the burden of emotions, making
one totally unable, in spite of being conscious of
one’s problems, to have proper control over
them…’
In full agreement with this point of view. I
may sum up s follows what I have learnt from
my own personal experience: the sphere of the
Staphysagira action is, but not exclusively, that
of failed repression of sexual impulses.
Staphysagira is, first of all, the Amica of the
psyche, the medicine for stress that is difficult to
absorb because it creates actionless revolts,
vexations without being able to defend oneself,
revengeless humiliation, the medicine which
helps to resorb ‘the bruises of the soul’, or I
could sya the haematomas of the heart. Just as
we find it indicated for the relief of the sequels
which may follow some cutting surgical
interventions (prostatectomy, treatment of hernia
followed by crursal neuralgia, hysterectomy) in
which the symbolism of sexual amputation is
evident.
For the adolescent, it may be called; the
medicine of the ‘cracked mirror’, when the eye
of the other (father, friend, partner) is reflecting a
poor of himself. Everything is there; perceived
stress, aggression turning back to oneself,
difficulty in finding one’s identity. Always it is
amazing and comforting to verify that
Staphysagira, when given in proper time, can
repair the injury and heal up ‘the wound’,
working to prevent psychotic disintegration,
enclosure inside a phobic neuroris or escape into
delusion.
This is the medicine of the ‘impossible
repression’, whatever its origin my be, which
clears situations of conflicts and avoids a
pathology of psychosomatic displacement.
And, above all, here we have a great
disinhibitor, enabling the expression of hidden
trauma. In psycho-analytic terms, ‘the return of
the repressed’ through a liberating reinforcement
of the impulses, due to its pharamacological
effect.
One must be careful when giving the
prescription (potency, frequency of repetition) to
estimate the reactional possibilities of the
patient. It is sometimes necessary to wait before
any further medicinal or psychotherapeutic
intervention, allowing time for the full action of
Staphysagria, in order to avoid any risk of auto-
aggressive reactions, sudden and violent attacks
against other people or a depressive
decompensation.
*************************************
STAPHYSAGRIA –
CORRELATION OF
ANATOMIC CLINIC,
Alexandre
MACHADO
‘Selections from the
Transactions of the 42nd
LIGA, 1987 –
ARLINGTON,
WASHINGTON,
USA.
First Matter: The drug Staphysagria is
made up of Delphinum Staphysagria L. Seeds.
Drug description: Seeds are strongly
compressed inside the follicle, at five or six, into
an egg-shaped mass isolatedly. The shape is that Pharamacology: Toxic seeds may cause
of a flat irregular tetrahedron, 5mm on each side, poisoning with vomiting, diarrhea and death.
one of the sides being convex; the others are 2 tea-spoons of the seeds cause: failure,
even or concave. weak pulse, gastrology, irregular breathing. At
The dark grey surface presents a salient autopsy a sore gastric mucosa full of ecchymosis
netting delimited by alveoli. The brittle is seen.
integument contains abundant albumin, oily and The seeds cause palsy of the sphincters.
white in fresh and live condition, dark yellow at In man delphinine causes a reddish and sore
desiccation. The small embryo is located near the skin, oedema of the tongue. Internally a 0.015 g.
microphyle; if crushed it releases a strong, dose causes: pharyngitis, salivating, nauseas,
disagreeable smell; it has a bitter, burning taste. skin itching, urge to urinate and to defecate.
Habitat: In the Mediterranean region at low On the scalp the alcoholic extract causes,
altitudes, on the prairies, arid regions. In the eczema on the face and on the hands. It affects
United States of America, Canada, Southern the locomotor system causing lack of
Europe (the meridional part), the Near East, coordination and ataxia, arrhythmic pulse, and
Northern Africa… reduces general sensitiveness of the respiratory
The Principle: The mother-tincture of function; arryhythmias with spasms of the
Staphysagria is prepared in 65% v/v ethanol, respiratory muscles; lack of coordination of the
from the seeds and in compliance with the striated muscles and of the heart muscle; CO 2
general techniques for preparing mother- increase in the blood; death due to respiratory
tinctures. failure.
Features: A liquid of light yellow colour, of Delphinine acts in a way similar to
rancid smell, bitter taste. aconitine, i.e. paralyzing the heart and breathing.
Indentification: 1. Put 1ml. TM n 1 ml. of water Staphysagrine seeds are popularly known
– this produces a milky misture. for their specific action in headaches and
2. Evaporate 2 ml. TM, put the residue in 1 ml. baldness. Delphinine acts in a way somewhat
of diluted R hydrochloric acid and some drops of similar to veratrine or are used against worm –
a mercury-potassic R solution; this will form a infestation.
precipitate. 1. GENERALACTION
Chemistry: The seed contains: 34.7 to 35.4% of It acts upon:
a fatty oil. 1.22 to 1.35% of an alkaloid inside sychotic medication (ZISSU)
the albumen namely: Genital-urinary mucosa
Delphine C33H45NO9, C19H21 (N-CH3) – Digestive mucosa
OH (OCH3) 4 – (OOCC6H5) (OOCCH3) Respiratory mucosa
Delphinine C24H29N07 Skin
Staphisine C42H60N02 Bones and Periosteum
0.02% of essential oil – brownish red. Central nervous system and the sympathetic
CLEMO and NATH isolated a new alkaloid; nervous system
C29H29O6N Medulla
Circulatory system
 Lymphatic system anger, indignation, humiliation, distress due to
Bleedings due to surgical instruments after onanism and sexual excesses,
an incision. tobacco,
Surgical operation pressure, movement, touch (painful hyper-
Glans (KENT) hysteria), pressure (tooth-ache and colic)
Prostate gland after eating, and meat,
Ovary prior to full-moon.
Testis, lymphatic ganglions Amel:
2. CHARACTERISTIC INDIVIDUAL heat
TABLE night rest (except: lumbago)
a. Constitution and Temperament: Pale, after eating.
depressed, downcast features, jealous, shy, e. Causality Anger, suppressed or heldback
sentimental, conceited, impetuous, anger, surgical injury, pains (wounds and ulcers),
hypersensitive, restless, loses temper easily, coitus, masturbation, sexual abuse, abuse of
slender nose, half-closed eyes, is very sensual mercuries, tobacco, Thuya abuse, teething.
abusing the sexual organs, onanism. f. Excretion Excretions from the mucosa, ulcers
b. Moral: Excitability, gets easily internally and sweats are irritating and have bad smell.
irritated, dose not permit his anger to show, g. Desires Wine, cognac, alcohol, tobacco, milk,
continuous indignation, with organic bread-beer and soups.
repercussions of them, e.g. to urinate constantly, h. Relationship Antidote per Camphor and
sleeplessness, fatigueability, brain does not work antidote: Mercury and Thuja
(commits mistakes speaking, writing), poor Incompatible: Ramunculus bulbosas
memory, load between the eyes, brain feeling Supplementary: Colocynthis, Causticum
exhausted, void. After onanism becomes 3. SYMPTOMS
indifferent, downspirited, mind becomes stupid, I. Mental: Sensitive to any mental impression
irritated, worn-out, excited. Trying to control (words, criticism) (undeserved) insults, feels
their emotions, they may easily lose their voice, angered but cannot respond, silent sadness, feels
limbs shake, working inability, chronic easily offended; such indignation expressed by:
headache, preventing sleep. paleness, chronic headache, gastralgias, colics,
Exaggerated moral and physical diarrhea, coughing, oppressed chest, throbbing
hypersenitiveness: palsy, fever, sleeplessness and sweating.
These are people highly sensitive to noise, taste, Mental effect of onanism and sexual excess
touch, smells, pain. Any sore skin spot is very (apathy, hypocondrium, indifference, poor
sensitive. Felling of strong compression, bone memory), weakness in general.
pains during the night. Peevishness, irritability, hypochondriac, apathic,
c. Laterality conceited, jealous, sentimental, bashful,
Right (CHIRON) scrupulous, conscientious, fear of darkness,
Left (DUPRAT) kleptomania, get frightened easily.
d. Modality Children (restless, hypersensitive, impetuous,
Agg: rejects what is given to him or her).
II. Head: Chronic headache when annoyed, Black, sensitive teeth that cannot stand dental
anger after ingesting meat. Frontally pressing work nor cold water
chronic headache agg in the morning at waking Odontalgia during menstruation.
up am at rest or when leaning head against VIII. Mouth:
something hard. Temporal and occipital chronic Spongy gums that bleed easily, pyorrhea cysts in
headache. Scalp neuralgia. Rheumatic pain and the salivary ducts.
delineated pain externally of the head. X. Appetite:
Crustz eczema on and behind ears, occipital Desire for: milk
region, lateral to the head, wet, fetid, violent tobacco
itching. Hair loss. liquid food (soups)
III. Nervous system: 1. Central (brain- wine
medullarsphere) – depression with irritability brandy
(apathy, hypochondria, sexual ideas). Bulimia, even after eating.
2. Neuro-vegetative-sympathetic hypoesteria XI. Stomach:
Diminishment of the visceral function Belching in an empty stomach
Vascular relationship (bradicardia, PA arterial Load and pressure in the stomach, in the
extasis). morning upon waking up with nausea
IV. Eyes: Feeling of a ptosic stomach, relaxed, hanging in
Chalazium on the upper lid. a void or inside the abdomen
Recurretn styes that suppurate easily, upper lid. Worsens after snacks, or eating meat or drinking
Steatome of the lid alcobolic beverages.
Nodosity of the lid edge XII. Abdomen:
Post-operatively after a cataract intervention (Hepato-biliary) colic
Persistent catarrh with swollen lids Swollen abdomen in children with flatus
Nodules and tumours of the Meibomius glands. Incarcerated warm flatulence, smelling rotten
V. Nose eggs
Sneezing without coryza Inguinal hernia
Obstruction with a nasal voice Post-operative abdominal pain
Coryza with obstruction, sneezing and tear- Colics after episodes of anger, with urge to
shedding urinate and to defecate
Facial neuralgia agg. cold water in the mouth XIII. Faeces and anus:
and masticating Constipation, frequent urges with little
Facial eruptions agg. cheeks, in the peribuccal evacuation, associated with a herpes-sensitive
region and on the upper lips. contact haemmorrhoid with hypertrophy of the
VI. Ears prostate
Retroauricular eruption Diarrhoea agg. after cold beverages, after anger,
Deafness at childhood with hypertrophic adenoid eating.
VII. Teeth: Diarrhoea in children agg. after eating, after a
Premature tooth cavities in children punishment.
Involuntary loss of faeces at moment of releasing Ovaritis with pain radiating along crural region
flatus Amenorrhea due to grief, indignation
Anal inching when seated. Uterine prolapse
XIV. Urinaty organ: Irregular, abundant and retarded menstruation,
Feeling of a bladder right after having urinated pale blood, then dark with clots
Pain in bladder after a lithotomy Menstrual loss after menopause
Urine retention during puerperium Post-coitus suffering in newly wed women.
Action at the functional level: irritated bladder in XVII. Respiratory organ:
a newly wed female with daysuria agg. after Hoarseness, with adhering mucus in the larynx
coitus. and in the lungs
Action at the organic level: drop-after-drop urine Feeling of imprisonment and contraction in the
in an adenoma or hypertrophy of the prostate, throat after passionate out break, upon
frequent urge to urinatie, little urine at the swallowing
urination, pain and dropping after urination. Harshness and painfulness of the larynx after
Acute urine retention in prostatic patients much speaking
Cystocelis Dry cough caused by itching in the larynx
Action at the sensorial level: poloquiuria in the Violent cough with expectoration of viscous
newly wed after the first difficult sexual mucus at night after lying down to sleep
intercourse. Violent, spasmodic cough, yellow catarrh less at
XV. Male sexual organ: night.
Chronic prostatitis in old men, with pain Cough caused by cigarettes.
extending from anus along urethra. Increased XVIII Chest:
sexual urge with frequent erection, especially at Herpetic eruption on ribs; it burns and itches
night. Itching in the voluptuous scrotum with Cramp of the diaphragm after passionate
concomitant erection. Frequent pollutions with outburst.
chronic headache and exhaustion, lumbar pain XIX. Heart:
agg. at night. Effect of masturbation: thin face, Throbbing worsened by intellectual fatigue, upon
deep-lying and melancholic eyes. Occipital pain, listening to music, after meals.
weakness of legs, relaxed sexual organs. XX. Neck, nape of the neck and spinal column
Psychosomatic action: sexual obsession, Pressure, pulling, tension with stiffness,
frequent erection, onanism. Dry (LATHOUD) or weakness of the neck muscles.
west (VISINOWSKY) warts, sensitive in the Pruriginous eruption on the nape of the neck
gland. Acute orchitis with swollen and hard Lumbago agg. rest, after coitus, sexual excess
testicles. Pain agg. left side when walking, the getting up from bed
ardent, tyrannical quivering type. Lumbar abscess
XVI. Female sexual organ: XXI. Limbs:
Nymphomania with extreme mental Feelings as if of a painful blow, after long walks.
sensitiveness and fine impression Generalized pain in lower limbs
Sensitiveness in the genital organs when seated a) Upper limbs
Vulvar itching – senile itching
Pains, twinge on shoulder agg. touch movement Frequent boils
in the morning Skin suppurates easily
Pain in the bones of the arm agg. movement Eczema on face, ears, irritating, thick yellowish
Pressure, palsy, pain on forearm, shoulder. hands crusts, dry and fetid. Upon Scratching the itching
and finger agg. seems to move place.
movement, touch Peduncular and dry warts, cauliflower-shaped
Herpes on hands, elbow Condylomas
Arthritic nodules on figure joints All of these lesions are present predominantly in
Cramp, numbness in the fingers cephalic extremities, nape of neck, ears, eyelids,
Osteitis of the phalanx. nostrils
b) Lower limbs Rheumatism alternating with disturbances of the
Pain in bones at night skin
Crural neuralgia XXIII. Sleep:
Pain in buttocks when sitting down Stranger tendency to sleep during the day and to
Acute osteomyelitis, especially in the phalanxes remain awake at night
of the fingers and in the metatarsal bones of the Restlessness in the lower limbs
foot and in the tibia, with fever and Lascivious dreams with pollutions
sweatlessness Sleep disturbances, anxious dreams,
Gout, not acute paroxysm, but rather when the somnambulism
urate excreted in the urine gets deposited in the Sleep delayed due to flow of ideas, itching on the
joints in the form of a “tophus” nodulosity. body, burning feeling, pain on feet.
Generalities: XXIV. Fever:
Incarcerated gases, with flatulent colics Fever at night, with shivering and feeling cold
Pain in the zygomatic region and lower jaw agg. 3 p.m. It starts on the neck, goes up to the
Eye corners affected head and returns.
Illness of the right ovary Feeling hungry before and after paroxysm of
Polyps intermittent fever
Arthritic nodules Tertiary fever, with bitter taste, gums bleed,
Painful inflammation of the bones anorexia and constipation, burning heat on head,
Suppuration of the bones and periosteum very thirsty at night and shivers early in the
Swelling of the bones morning. A tendency to perspire during the day.
Semi-palsy after annoyance *************************************
Fainting spells
REMEDIES WITH
Painful sensitiveness in all muscles when OPPOSITE
touched MODALITIES
Severe fatigue upon waking up, with pain in the
J. MÜNZLI
ZKH, 27, 5/1983
joint moving them
Relieves cancer pains In the following will be found a list of
Menstrual odontalgy remedies in which you will find modalities
XXII. Skin: which are opposite as between particulars and
generalities or opposite in peculiar general or Symptoms of head and breathing agg. from lying
local modalities. The material has been drawn Causticum:
from KENT’s Lectures on Materia Medica. Generally chill and rheumatic;
Aesculus hippocastanum: bathing and washing agg;
External ailments (stitches): warmth amel; Head and eruptions better from cold washing,
Internal ailments: warmth agg. - cough better from sip of cold water.
Allium cepa: Chamomilla matricaria:
Open, cold air amel. General agg. warmth; General amel: warmth;
Cough from cold air Throat and tooth complaints worse from warmth.
Ammonium carbonicum: Chelidonium majus:
General agg. cold; General am: warmth
Desires cold in head ache with amel. Headache caused and agg. by warmth.
(except ailment of external head) Cimicifuga racemosa:
Baryta carbonica: General agg: cold
General agg cold; Headache am. by cold
Headache better by cold Clematis erecta:
Belladonna atropa: Cold applications aggravate eruption;
General agg: motion; Cold water am. toothache
Sciatica better from motion, rest agg. Coccus cacti:
Bryonia alba: General agg: cold;
General agg. warmth; Cough agg. from warmth (air, room, bed, warm
Stomch and abdomen better from warm drinks drinks) and amel.
and applications. from cold (air, room, drinks)
General am. pressure; however not stomach and Coffea cruda:
abdomen General agg. cold;
(this holds for head partly) Tooth and throat pains better from ice-cold
Caladium seguinum: water.
General agg. warmth; Colocynthis cucumis:
Stomach better from warm drinks. General agg: rest;
Calcarea phosphorica: Eye pains are worse from movement of the eyes.
General agg. cold; Cyclamen europaeum:
Desires for cold compresses in headache General agg: motion;
Cannabis indica: Pains and head better from motion.
Movement agg. in general General agg: cold;
Mental symptoms better from slow walking. Cough and coryza am. by cold.
Carbo vegetabilis: Euphrasia officianalis:
General lack of heat Cough, breathing and fever better from lying;
Only in coryza feverish. Catarrh worse from lying down in the evening.
Caboneum sulphuratum: Ferrum metallicum:
General amel; lying; General agg; cold;
Facial, neck and tooth pains better by cold. Cough is worse in warm room.
Ferrum phosphoricum: Mercurius solubilis:
General agg: cold; General agg. nights;
Head and tooth-aches better by cold. Coryza mostly in day, when out of bed, worse;
Glonoinum: warm agg, nights
Wants cold on head; Nasal catarrh better from hot air.
Wants warmth on the cold extremeties. Mezereum daphne:
Gratiola officinalis: Agg. from change of weather, stormy weather,
Fresh air and open air amel. most of the ailments dampness,
Diarrhoea will be agg. by it. bathing and cold
Guaiacum officinale: Eruptions agg. from warmth and bath, better
Least motion agg. all pains: from cold
Headache better from moving about and Internal and external ailments worse from
pressure. warmth of bed and nights.
Ignatia amara: Neuralgia better from warm, worse from wet
General amel. warmth, cold.
Wants could in the stomach. Natrum arsenicosum:
Iodum: Rather worse in open air,
Desires motion; Mental symptoms better in open air.
Headache agg. much from motion Natrum carbonicum:
Kali iodatum: Body and extremities worse in winter;
General agg: warmth; Head is worse in summer
Biparietal headache is better from warmth Natrum muriaticum:
General amel. fresh air; General amel. perspiration;
Nasal catarrh agg. by fresh air Headache will not be amel. by perspiration.
Cold am. externally; Nux vomica:
Cold agg. internally Desire for warmth, warm room, warm bed;
Lac vaccinum defloratum: Head and catarrh would be worsened thereby
General agg. cold particularly warmth of bed.
Head ache amel. by cold Nitri acidum:
Lycopodium clavatum: Warmth generally comforting:
General amel: warmth; Cough will be worse from becoming warm and
Headache, spinal pains are not better from in warm room.
warmth; Oxallcum acidum:
Ulcers agg. from warm applications. Pain worsened by motion:
Magnesia muriatica: Back ache and sciatica better from change of
Chilly but bettering the open and in fresh air; position.
Head worse from fresh air Phosphorus:
Medorrhinum: General agg. cold;
Generally warmth feels good; Head and stomach want cold which amel.
Psorinum: Cold agg, General amel. warmth;
General agg. in open; Warm drinks agg. headache and nausea
Eczema of head better in open. Thuja occidentalis:
Pyrogenium: Pains worse from warmth;
Motion and heat amel. restlessness and muscles; Eye pains amel. from warmth
Motion and heat agg. cough, abdominal and Veratrum album:
heart ailments. All pains worse from warmth;
Ranunculus bulbosus: Warmth amel. a cold abdomen.
Pains worse from motion, This could be reason for failures with
Pains upper half of right eye worse from rest; repertorisation by BPENNINGHAUSEN’s
amel. from walking around and standing methods
Rhododendron chrysanthum: The general and particular modalities of a
General amel. motion; remedy are not always identical. Sometimes they
Affected part (joint swelling, facial neuralgia) are contradictory, sometimes different modalities
often agg. from local movement, general of generals or particulars are contradictory.
movement amel. *************************************
Ruta graveolens.
GOOD NEWS
General agg. from cold; ABOUT YOUR
Insatiable desire for cold water. HEART,
Sabina juniperus:
PEKKANEN John.
‘Reader’s Digest’
General agg. warmth;
August 1991.
Menstrual ailment better from warmth
Bob FINNELL’s life-style caught up with
Secale cornutum:
him at the age of 48. In 1985, medical tests
General amel. cold;
showed two of his coronary arteries were
Cold agg. headache (neuralgic) and burning of
completely blocked and a third was nearly
skin.
closed. Sometime in the past, he learnt, he had
Pulsatilla pratensis:
even suffered a “silent” heart attack.
Acute: Chilly
FINNELL had travelled a familiar path to
Chronic: sensation fo head and thirstless.
the brink of death. He put in long hours and went
Silicea terra:
without vacations to stay on top of a demanding
Acute: heat waves
job. “I was always in a hurry”, says Finnell. “I’d
Chronic: Chilly
take a taxi to go three blocks. I’d rush to the
Chilly, desires warmth;
airport and make last-minute phone calls before
Stomach wants cold (comp. Puls)
boarding a plane”. He also kept a tight lid on his
Spigelia anthelmis:
feelings.
Eye pains (neuralgia) better from cold, worse
While FINNELL was a non-smoker with
from warmth;
normal blood-pressure, he loved high-fat
Shoulder and neck pains worse from cold, better
cheeses, meats and rich desserts. He was almost
from warmth.
20 kilos overweight, and his blood-cholesterol
Theridion curassavicum:
level was high. Finnell’s cardiologists
recommended by pass surgery, but Finnell
thought, There must be another way.
At the University of California at San
Franciso Medical School and Pacific
Presbyterian Medical Centre, Dr. Dean
ORNISH, a young, soft-spoken researcher, was
recruiting patients for a new heart-disease
treatment. Earlier in his career, ORNISH had
studied by pass surgery. Ultimately, however, he
became concerned that it addressed only
symptoms and not causes.
“It was like mopping up the floor when the
sink overflows without also turning off the tap”,
the 38-year old doctor says. “We had patients
coming back five years after their bypasses with
the same disease. So we’d bypass the bypasses”.
Newer, less drastic meical techniques did
little to change ORNISH’s mind. In coronary
angioplasty a balloon catheter is inflated inside a
blocked artery to open it up. “But a third of
arteries opened this way clog up within six
months,” ORNISH notes.
Another option, cholesterol-lowering drugs,
while promoting in certain cases, can be costly.
Patients on such drugs may lessen their changes
of dying of heart disease, but in some people
these drugs may have adverse side effects.
“With these various interventions”, says
ORNISH, “we often end up trading one set of
problems for another. I wanted to address the
causes of heart disease”.
Early Volunteer: It is known that diet, smoking
and other life-style factors are the underlying
cause of much heart disease. ORNISH hoped to
learn whether changing one’s life-style would
not only halt the progress of heart disease, but
even reverse it. It was a radical idea.
Conventional wisdom held that once plaque
narrowed a coronary artery, only such invasive
procedures as surgery and angioplasty could
widen it again.
At first, ORNISH found little support. The
US National Heart, Lung and Blood Institute
(NHLBI) turned down his grant request. So did
several foundations. Turning to private
contributors, he raised barely enough to begin his
research.
With Dr. Shirley BROWN and research
psychologists. Larry SCHERWITZ and Jim
BILLINGS, ORNISH set up head-quarters
outside San Francisco. As his test subjects, he
recruited patients who had just undergone
coronary angiography – X-ray studies that show
the precise extent of heart disease. To guard
against bias, a statistician would randomly assign
patient either to a group that received the
experimental treatment or to a comparison group
that followed their own doctors’
recommendations for diet and life-style changes.
Among the first patients who volunteered
was Bob FINNELL. He and 27 other were
assigned to the experimental group, and another
20 to the comparison group. All 43 men and five
women, aged 41 59 71, had very serious heart
disease.
SCHERWITZ called the study the Life-
Style Heart Trail. For the experimental group,
the ground rules were simple. Anyone who
smoked would stop. Everyone would eat a low-
fat vegetarian diet-no meats, poultry or fish.
While there would be no caloric limitation,
cholesterol intake would be limited to five
milligrams a day, and calories from fat would be
held to ten percent of the diet. Caffeine, cheese
and egg yolks were banned. To be included in
the diet: fruits, vegetables, egg whites, grains,
legumes, pasta, skim milk, non-fat yogurt and
herbal teas. Moderate amounts of alcohol and
sugar were allowed; salt was restricted only for
those with hypertension.
Participants were to walk a half hour a day
or an hour three times a week. Convinced that
psychological factors play a major role in heart
disease, ORNISH included mental relaxation and
stress-management techniques in his
experimental group. After week-long training
sessions, the test subjects returned home,
agreeing to meet twice a week. All kept a record
of the food they ate and of their exercise and
anti-stress routines.
Recently ORNISH published the results of
his study in a new book, Dr. Dean ORNISH’s
Programme for Reversing Heart Disease. Six
people in the experimental-treatment group did
not complete the testing. Among the remaining
22 participants, 18 (82 per cent) showed reversal
of their coronary-artery blockages after one year.
Three showed no significant change, and one
actually got worse. “This person did not follow
the programme”, ORNISH says.
In the comparison group, one person
dropped out, and ten of the remaining 19
developed measurably worse heart disease, while
three showed no significant change. On average,
the arteries of patients in the comparison group
closed an additional eight per cent.
Landmark Study: Significantly, six people in
the comparison group showed measurable
reversal. This was because, says ORNISH, they
made life-style changes on their own. “They
exercised more”, he notes,” and they cut their fat
and cholesterol intake”.
The results of the Life-Style Heart Trial
caught the attention of the medical community.
Dr. ALEXANDER LEAF, former chairman of
the department of preventive medicine at
Harvard University Medical College, says, “For
the first time, we have a carefully done scientific
study that shows, even in advanced stages, this
disease can be reversed with life-style changes.
This is a landmark study”.
Meanwhile, ORNISH’s findings have
prompted sizeable grants from the NHLBI and
private foundations to learn if reversal will
continue. The evidence thus far suggests that it
will. FINNELL, who had the worst blockages in
the study, felt “tremendous improvements”
during the first year and “even bigger changes
between the third and fourth years”. Tests
confirmed this.
Because more severe blockages were years
in the building and often more calcified,
ORNISH thought they would be more difficult to
reverse. Yet, surprisingly, this was where the
greatest reversal occurred. The average blockage
in the experimental group shrank 5.5 percent, but
the most severe ones regressed nearly nine
percent. Notes ORNISH, “Even a small reversal
in a severe blockage can cause a great
improvement in blood flow”.
Remarkably, ORNISH’s patients
experienced a 91 percnet reduction I frequency
of chest pain, mostly within the first few weeks.
When he started the regimen, Werner
HEBENSTREIT, now 76, the oldest study
participant, could not even shave without angina
pain. “Now I can hike four to six hours at a
time”, he says. Instead of taking two dozen
cardiac pills a day, he is down to one infant-dose
aspirin every alternate day.
ORNISH also discovered that a person’s
blood – cholesterol level may not be as important
as the consumption of cholesterol and fat.
ORNISH had assumed that cholesterol levels
below 150 milligrams per deci-litre would be
needed for reversal. Because of a genetic
predisposition, one patient, Robert ROYALL,
55, had an excessively high cholesterol level,
and the rigid diet lowered it only to 260 – still
high-risk. Yet his heart disease regressed, as did
that of another patient whose cholesterol never
fell below 200. This underscores ORNISH’s
view that diet and other life-style changes, not
cholesterol-lowering drugs, should be the first
step for people with high cholesterol levels.
A Race to Death: As important as he found diet
to be, ORNISH says his study only reinforced
his view that heart disease is far more complex
than we realze. He points out that traditional risk
factors explain only about 50 percent of heart
disease. Clearly, somethings else is involved.
And a big part of that “something else”, he
believes, might be stress.
Evidence of that shows up in the one patient
in ORNISH’s study who died. At 49, the man
ORNISH calls Sam was a world-class runner,
race walker and cyclist. He was also, he told
ORNISH, a former Olympic athlete. After racing
one day, Sam developed chest pain. Tests
revealed several blocked coronary arteries.
Following an unsuccessful coronary
angioplasty, Sam joined ORNISH’s programme.
he followed the vegetarian diet faithfully, and his
cholesterol dropped from 294 to 121. Because
Sam seemed excessively competitive, ORNISH
asked him not to complete during the study. But
ten months after entering the programme, he
competed against other “rowers” on a televised
rowing exercise game at local gym. The faster he
rowed, the further ahead of his competitors he
got. After an hour, he announced proudly that he
had finished 150 boat-lengths ahead. Moments
later, he died of a heart attack.
Soon after, ORNISH learnt that Sam had
never been as Olympic athlete, as claimed. “For
Same”, ORNISH writes “the stress came not
from exercising but from the competitive attitude
that he took towards it”.
Sam’s death, ORNISH continues, “was a
tragic but powerful lesson for me. It’s not
sufficient simply to change behaviours like diet
and exercise. We also need to consider what
underlies the behaviours”.
While certain Type A behaviours, such as
impatience and tendency to do two or three
things at a time, do not appear to be linked to
heart disease, other are. Citing research at Duke
University, ORNISH concludes that behaviours
“most toxic” to the heart are self-involvement,
hostility and cynicism.
“You can’t remove stress from people’s
lives”, ORNISH says, “but you can diminish its
effects by improving the way people react to it”.
Yoga, including a relaxing regimen of
stretching and breathing exercises along with
meditation, became a key part of ORNISH’s
stress-management programme. He defines
meditation as “a focusing of the mind for a time
on a sound, a word, a prayer – a way of quieting
the mind and body and experiencing inner
peace”. Many studies have shown that
meditation lowers blood-pressure.
In ORNISH’s Life-Style Heart Trial, stress-
management took about an hour a day. Almost
all participants reported a big improvement in
their stress tolerance.
Is It Practical? While the scientific validity of
ORNISH’s study is not in question, he does have
his doubters. “ORNISH’s results are valid for the
people in his study”, says Dr. HENRY
GINSBERG, an associate professor of medicine
at Columbia University and a member of the
American Heart Association’s (AHA) nutrition
committee. “However, it is impossible to say
without larger studies whether his results would
apply to the entire population. But the real issue
is whether his results are practical for the whole
population. I don’t think most people would be
willing or able to follow his regimen”.
The AHA itself has also suggested that
ORNISH’s regimen is impractical and stated that
it would not modify its diet recommendations.
The AHA calls for limiting the calories you get
from fat to 30 percent of your total rather than
ORNISH’s ten percent. ORNISH responds:
“People have followed our programme for more
than five years. The reason is that they feel
better. I suspect there are a lot more people than
we think who would make comprehensive
changes. Not everyone would want to, however,
and for these I have no hesitation in offering
drugs or surgery”.
Moreover, ORNISH feels such criticism
misses the point. “What I wanted to do”, “was to
find out what works, not what is easy. Giving up
smoking is hard, but it doesn’t stop us from
advising people to do so.”
ORNISH is also surprised by the suggestion
that his regimen, which poses little risk and
would cost most patients very little, is “radical”.
Especially, he adds, when such potentially risky
interventions as bypass surgery, angioplasty and
powerful drugs are considered standard therapy.
Dr. ORNISH’s programme can also be
practiced as preventive therapy, which requires a
less stringent regimen than reversing heart
disease does. For people with high cholesterol
levels, ORNISH suggests gradually reducing fat
and cholesterol consumption until the level falls
to 150. Also, incorporate exercise into your daily
routine – walk to work or take an after-dinner
stroll.
Learn to manage your stress with stretching,
meditation and simple breathing exercises. Deep
breathing – in which air is inhaled into the
abdomen, held briefly and slowly exhaled – can
be done throughout the day, even while you’re
waiting for a traffic light.
“The benefits of our programme,” ORNISH
concludes, “are not confined to heart diseases,
but may apply to other illnesses as well. The
more we learn about disease, the more we realize
it often arises from a combination of physical
and psychological factors. All of these need to be
addressed”.
Bob FINNELL can attest to that. while his
heart has shown remarkable improvement, he
believes the biggest change is in his head. “It’s a
mistake to focus too much on the physical
changes. The mental and emotional
transformations are more important. If I were
told this was all a mix-up and I had no heart
disease, I would still follow the programme”, he
says. “It has probably given me a much longer
life, but it has certainly given me a much richer
one”.
*************************************
INSIDE MADNESS
Steven HUGHES
‘Br. Med. Journal’
Vol. 301, 1990.
“It’s a funny thing, stress”, said the boss,
little realizing how prophetic his words would
prove to be in the ensuing month. He was a
worried surgical consultant comforting an even
more worried surgical trainee.
The previous night, Saturday, on call in a
London teaching hospital, I had suffered a
profound, incapacitating, panic attack. For no
obvious reason I had suddenly been
overwhelmed by a crescendo of blind
unreasoning fear, defying all logic and insight.
Bewildered and summoning my last reserves
of concentration, I had referred myself to the
duty psychiatrist and had been sedated and
admitted to the psychiatric ward of may own
hospital.
As an army medical officer I had served in
the Falkland Islands campaign in 1982, but
nothing that General Galtieri’s men had
generated compared with the terrors that my own
mind invented that night. Having looked death
full in the eye on a windswept isthmus that night.
Having looked death full in the eye on a
windswept isthmus outside Goose Green and
again, but two weeks later, on a barren hillside
called Wireless Ridge, I think can honestly say I
no longer feared death or the things real and
imagined that usually become the objects of
phobias. I was afraid that night of the only things
that could still frighten we, myself, I was
terrified of losing my control.
No logic could rationlise what had
happened. I could not let go in case I lost control,
and the more I battled against my fear the more
the panic increased. I had been completely
physically and mentally exhausted when they
had sedated me. Now, in the cold light of Sunday
morning, with my parents and my consultant
with me, I was feeling foolish but far from sane.
What had happened to me? What was to stop it
happening again?
In an effort to save me embarrassment the
psychiatric staff tried to find me a bed in another
London hospital. It took several hours on the
telephone but eventually one was found. I was
transferred to a world center, where I was
admitted by the duty registrar. He apologized,
the only bed available was in a forensic
psychiatric ward. Thus, an hour later, I found
myself in a side room (a cell), in a ward for the
criminally insane. I amused myself with the
thought that two years with the parachute
regiment must equate to a criminal record. I
couldn’t be completely mad if I could still smile
at my predicament.
So far I had been seen be a senior house
officer and a senor registrar at my own hospital
and a registrar and a senior registrar at the
second hospital. Sedation had been started and
subsequently stopped. I had been clerked several
times, but the only person who had really
communicated with and helped me was the
senior house officer on the night of admission,
the newest recruit to the speciality. We had met
once before when he had been a medical senior
house officer and I a surgical registrar in another
hospital.
I struggled not only to regain but also to
retain my sanity in an environment our of One
Flew Over the Cuckoo’s Nest. At least the nurses
in the film wore name badges and uniforms.
Here, you could barely tell staff from patients.
Who were the minders and who were the
minded? Drugs were dispensed on the Pavlovian
stimulus of a bell and the summons to
“medication time”; patients shuffled in a queue
to receive their pills from a hatch.
Never the same face
After 48 hours in hospital I started to get
restless. I wanted to see the same face twice. I
wanted to know why it had happened. I knew
that getting agitated was counterproductive so I
lay on my bed to try and calm down when one of
the nurses came in to tell me I had 30 minutes to
pack for the move to another hospital. I pointed
out that someone ought to tell my parents, who
would be setting off to visit me, and that I
needed my wallet from the safe.
Hurriedly bundling my possessions, I was
escorted to a waiting ambulance, only to be
asked to dismount as they didn’t yet have
clearance to carry me. Clearance eventually
forthcoming, we departed for one of the famous
Surrey “bins”.
The new ward was less forbidding, although
the absence of uniform or name badges and the
summons to medication proved to be the same. I
was told that I would be accompanied by a nurse
at all time – it seemed that I was now under a
close supervision order. There had been no such
restrictions on me until then. I was, after all, a
voluntary patient. I couldn’t now go for a pee
without my shadow, but this was short lived. The
duty psychiatric registrar came to admit me. He
was dressed reassuringly in a collar and tie; he
looked and talked like a doctor. We discussed
our attitudes to dress and patient’s expectations
of their doctor. We held similar opinions; until
recently he had been a physician.
Thankfully, he decided that I might be
agitated and depressed but that I was neither
dangerous nor suicidal. He dismissed my minder
but after he had gone one of the nurses appeared.
They had discussed me among themselves and
decided that if I wasn’t to have a minder they
wanted my ties and belts. Holding on to my
trousers and my dignity, I handed them over. In
jest, I volunteered that perhaps they should take
my plastic laundary bag in case I put my head in
it. The bag was confiscated, leaving me with an
untidy pile of soiled clothes.
I knew by now that things had got out of
control. I was no longer confident as a patient. If
I was going to keep things together I had to
assert myself. Thus I adopted my safe “doctor”
persona again. It was no use playing “patient”
because all that happened so far had served only
to destabilize me. The system wasn’t helping me.
At least I knew now what discharge entailed. I
would have to wait to be seen by the consultant
on his ward round at the end of the week. I was
discovering that psychiatrists do not share the
same time scale as other clinicians, particularly
surgeons. this only added to my sense of
apprehensioin and frustration.
During the three days waiting to see the
consultant acquired something of an entourage
of fellow patients. I found companionship and
comfort and they found re-assurance in knowing
someone who knew how to stall the system. I
found surprising talent and compassion besides
the sadness and torment: many remarkable
people with surprising abilities but temporarily
lacking the capacity to cope with the world
outside. It was us against the system. I became
indebted to my family and friends visiting.
Thank God for the telephone. It was easy to
imagine becoming lost ot the outside world. How
many souls have disappeared into the British
psychiatric archipelago?
On Firday I faced inquisition, passed, and
was duly realsed to my home for two weeks to
convalesce. Thus a fortnight later, more than a
little confused by events, I returned to work.
After 12 days it happened all over again.
Panic consumed me, again out of the blue, at
a trauma conference. I sought sanctuary in a
nearby casualty department. This time I really
thought that I was losing my grip on sanity. I
will never forget the bizarre fixations on
inanimate objects as I tried desparately to divert
my attention from the unhinging of my world –
an electric socket, a patient trolley – was this
madness?
Help from a young nurse
Human contact and understanding rescued
me. A young student nurse talked me out of the
fog and calmed me down until the arrival of the
psychiatric senior registrar. I related my story,
including the nightmare of my earlier stay in
hospital, and was by now much calmer.
Thankfully, he decided against admitting me. It
was a mark of my terror that, despite what I had
experienced two weeks before, it had been the
lesser evil to return for help to that system, but as
the panic passed anything was preferable to
another fruit-less stay in an NHS ward.
Agitated but functioning I drove home to my
country cottage, my only remaining sanctuary.
My parents came as soon as I called and stayed
with me that night and the next day. It was they
who persuaded me to contact a naval psychiatrist
friend for advice. As I put the telephone down
from speaking to him the penny finally dropped.
He had also been with the Falkland taskforce and
after speaking to him I flashed back. I suddenly
found myself back at Goose Green, in the rain
and the smoke and the horror. I felt again the
fear, the despair, the grief, and the anger; and
over-whelming maelstrom of emotions long
since buried deep in my soul.
I had PTSD – post-traumatic stress disorder.
Distraught by this stage, my parents did the
only sensible thing, they called my general
practitioner. He was superb – prompt,
professional calm, and reassuring. He had a
discussion with the military, and my admission
to a service hospital was arranged.
My subsequent treatment was the way out of
the abyss. The contrast with the NHS was stark.
Crisp pressed uniforms, mutual respect, and the
implied expectancy of return to normality and
duty were powerful advantages of dealing with
predominantly stress related conditions in a
service hospital. But is that beyond the NHS? It
was not pleasant, but it was the way to
normality. I started to address what I had never
acknowledged let alone come to terms with – the
hidden memories and feelings of those black
days of 1982. I had never had the time to release
the suppressed emotions that I had dared not
show as I fought to keep alive those gallant
young me, Argentinians and Brits, friend and
foe, on that desolate Goose Green isthmus.
Aware of the eyes of my medics on me, their
leader, I had got on, seemingly impassively, with
the job at hand, even when the bodies of some of
my closest friends lay only yards away.
Ultimate nightmare
With the seriously wounded needing
lifesaving help, there is no place for the cold,
still image of the friend, joking but a few hours
before, now with a 7.62 mm entry wound in the
middle of his forehead, his body half hidden
under a tarpaulin next to that of the charismatic
commanding officer we both so admired and
loved. Goose Green was my ultimate nightmare.
The subsequent memories of the Galahad
disaster and Wireless ridge pale into
insignificance by comparison. Whatever snapped
did so in the burning gorse at Goose Green. They
do say you can feel only one pain at a time.
Returning home to a society that had simply
watched another war movie on television, I never
seemed to get the space to grieve for my friends.
As time passed so I supposed and hoped had the
need. It was as if I had erased the emotion from
the tape in my head that records those memories.
Although I had instigated and cowritten a
research study on post-traumatic stress disorder
in Falkland veterans. I had ignored all the
symptoms in the mirror.
My rehabilitation is not over yet. Indeed, it
may never be. If even I come fully to terms with
the nightmare that is war then perhaps I will
have changed for the worse. Perhaps, by sharing
my experiences I can find peace. Certainly, the
process of treatment seems to be one of sharing
and thus dispersing the hurt. In a way it is like
the dissipation of energy, the greater the area of
impact the less the damage.
What can be learnt from my tale?
 Professionally, we must seek a better way of
treating sick doctors when it comes to mental
illness. Doctors have greater insight of the
system than most patients and are often treated
by staff and patients alike as aliens. For this
reason they are even more vulnerable to the
whims of the system and need special efforts to
engender reassurance, comfort and stability.
On an individual level, perhaps we should
strive to be less insular about our reactions to
stress, particularly when talking to each other.
Surgeons are hardly renowned for being caring
individuals most of us affect an impersonal,
impassive, protective façade. What surprised me
was the tremendous support of my surgical
colleagues, contemporary, and senior. The
almost universal reaction seemed to be, “If it can
happen to Steve could it happen to me?” It’s a
pity it takes a breakdown to elicit that support. I
would encourage any doctor in similar straits to
seek help early from colleagues – we’re only
human, no matter how invincible we try to
appear.
It was the young who coped and
communicated best with me. Honesty and
humanity are so precious.
Finally, my story represents only the tip of
an iceberg. It is not just other Falkland veterans –
somewhere in the region of 20% of the
combatants – and veterans of other military
conflicts who are having problems, or even the
survivors of the string of civilian disasters of
recent years. It is the individual whose personal
disaster does not rate media or, sometimes, even
medical recognition but nonetheless leaves him
or her psychologically damaged and, with the
increasing fragmentation of the family, less able
than ever to find help. Many, like me, will not
even be aware that they have a problem.
It is for these other victims that I regard the
telling of my story to be essential. In the words
of John BRADFORD, “But for the grace of
God…”
*************************************
NOEL’S
RESURRECTION
Charles SMITH
‘Br. Med. Journal’
Vol. 301, 1990.
This last person to see him alive was an Irish
prostitute. She shared his Dublin origins and had
London as a base. He was there to die there
anonymously, she to live anonymously. She had
finished another routine night’s work and,
unwinding wearily, she noticed him motionless
at the apartment window opposite. He held her
attention for two or three minutes before she
moved off to shower away the dirt and sweat of
her trad.
For NOEL the prostitute did not exist,
although others like her had in his relatively
short life. He stood there in the stillness and calm
of early morning London, the memory bank
intact and turning over. London goes to sleep for
a few minutes every night when stragglers
awake. He liked that gap, finding it reassuring. It
gave him the courage he needed to do what he
had to do. No more playing around. No more
talking. The time was right.
Two years before, almost to the day, he lay
in a hospital bed returning quite pleasantly from
a brush with death that left him without memory
of the accident or the subsequent week. It was lie
surfacing back into light and then noise, shapes,
and people. No real problem. Another battle
won, another risk survived. There was absolutely
nothing to let him know that life would never be
the same again. Everybody else in the ward, all
the staff, the patients, the cleaners, the visitors
even, they all knew that he had lost his leg
before he did and they were used to it by the
time that he woke up. He was not about to get
used to it, though, Never.
It happens to a lot of people. A lousy
accident followed by a battle to save the mangled
limb and a cold surgical decision to amputate.
Lots of people lose bits and pieces. They have
jobs, wives, husbands, girlfriends, compensation
– of course they recover. Some of them are even
improved by it all. You know the scene. The
tragedy brings a family together. Life is a bonus
not an entitlement. That sort of sell deception.
They go on living and denying. It would not be
like that for NOEL. Not at all.
He deliberated long and hard about killing
the surgeon, the on who failed to sew his leg
back on. They can transplant hearts and kidneys
and lives can’t they? But nobody had bothered to
reconnect his leg. He asked about that one
morning during the ward round and the
entourage thought it strange. You see, patients
are supposed to keep stupid criticisms and
questions to themselves, and what is more they
should be grateful and respectful towards
surgical and medial experts who save lives. One
young student nurse, more sensitive than her
seniors, was quite frightened by his inquiries and
the way he asked them and she knew he was
different. Not for him the usual subservience, the
expected cooperation in recovery. For NOEL
there was no chance of that.
Phantom sensations
He had plenty of time to think because he
was left alone in the ward. That is the way he
wanted it. No ties, no friendships, no obligations,
no commitments. he drifted through the days and
nights. Awake, he worried about the old bit.
What did they do with it? Burn it? Half awake,
half asleep, he was convinced more than once
that the leg had regrown and that he was whole
again. He had phantom sensations that convinced
him the leg was restored in place and he would
have to check again and again. He didn’t need to
check the pain, the anger, the frustration.
The student nurse was not the only one to
notice how different he was. years earlier, in his
small local primary school, Mr McDONAGH
decided to take on the non-conforming NOEL. It
seemed an unequal struggle with adult size and
role pitted against a child, a child with a
difference. This one never cried, never
apologized, never submitted, never showed fear.
NOEL won the long battle with Mr.
McDONAGH. McDONAGH gave up, but
NOEL lost out on the way. By the time that he
was finished with Mr. McDONAGH he had
arrived at a stage where he couldn’t laugh,
couldn’t paly, and he certainly couldn’t trust. AT
home it wasn’t much different because his father
seemed angry with him all the time as well and
nobody seemed to protect him – that’s the way it
felt. It was like a constant confusing war and he
didn’t know what side he was on most of the
time.
Somebody had to pay for what he had to put
up with. Someone else had to suffer. If no one
cared about hurting him why should he care
about hurting others? There was a score that had
to be settled and later, when he was bigger,
someone was going to get it. Perhaps Mr.
McDONAGH, perhaps someone who just looked
sideways at him. He never liked girls, although
plenty were attracted to him. He knew all about
physical sex by the time that he was 14, but he
knew nothing about being bowled over by a girl,
being madly in love, being vulnerable. No, that
was never to happen to him. He should continue
to get mean and perhaps a bit vicious.
 Nora McCAWLEY at the tender age fo 16
loved this handsome young warrior and whatever
he wanted she gave. He thought it was funny
when he once persuaded her to remove her dress
in a courting wood and he ran off with it, really
ran off. He didn’t return to end the joke, though
she waited, embarrassed and ashamed, for hours,
and she needed a Samaritan in a passing car to
rescue her and bring her to move humiliation,
first to a neighbour’s house and then to her
angry, confused home. Her parents banned and
barred NOEL and saved NORA a lot of misery
and pain. When he found out about their
rejection of him he thought seriously about
setting the McCAWLEY household on fire with
all of them in it.
Relief in hunting.
NOEL got some release from persisting
resentments when he took off into the
countryside to camp and hunt. With growing
insight he thought he was safer on his own and
the hunting, at which he quickly became skilful,
satisfied something im him, relieved him. It
wasn’t that he needed all that he caught or that
he enjoyed and contrived a slow, painful, curel
death for his prey, but the exercise soaked up a
lot of aggressive energy, leaving him more at
case, sated. All of that had gone on before and he
was already a moulded fighting machine with
aggressive energy to burn when the accident
exploded.
He had terrible trouble trying to master the
artificial limb. they eventually fitted it, if fitting
is what you call clumsy, ignorant, painful
strapping of lifeless steel and leather to living,
angry stump. He hated every hand that touched
him, every tape tht measured him, every eye that
glanced his way in the limb fitting department.
The technicians had seen a lot of reactions in
their time, but nothing ever like the killing looks
of NOEL when he quickly got fed up with their
impossible struggle to restore function that
would never approach normality.
The new limb hurt the old one and in warm
weather it got hot and sticky. It creaked and
snapped and announced his disability even
before his limb came into view. He was angry
with those who decided to risk talking to him
about his accident and suspicious of those who
didn’t who pretended they noticed nothing.
Anyone who seemed genuinely interested in him
was banished with insult or threat.
He was not about to discover religion or
anything stupid like that, but he would fantasise
a voyage to Lourdes, a plunge into the healing
waters and a re-emergence complete and
restored, never again to seethe, never again to
limp, never again to hate. Those thoughts
became his version of prayer. He didn’t believe
in his prayers and they went unheeded.
He wrote all of this down so that if
something terrible happened he would leave
some answer behind. A few drinks made another
type of fantasy increasingly attractive. This one
included finding a small, quiet business office
with three employees. Two young women and a
man. The door would lock and the shades go
down and the man would die. The women would
live for a while as he played a game. They had to
give the right answers to his questions to survive.
He would start off with simple stuff, moving on
to six markers. It was all rehearsed, their death
inevitable. It was sick really because what he
intended was worse than what he wrote down.
He recorded only the major components. He
didn’t tell about the sadistic torturing that he was
getting close to at that stage. Somebody had to
pay for NOEL’s anger and pain.
No one actually saw him jump but plenty
saw what was left of him. The 12 storey drop did
a good mincing job on NOEL and nobody, not delegate fee fro the Congress is US $100. Venue
even the ambulance crew, noticed his amputated of the Congress is Bandarnaike Memorial
stump. There was no sign of the artificial limb. International conference Hall, Colombo.
No sign of it in the street, no sign of it in the
jump room. It was gone forever. He was
thoroughly successful in destroying himself,
that’s for certain, but there was more to it than
that. His life was gone, finished. Some would
say good riddance; but other were alive and
would stay that way. That was NOEL’s sacrifice,
his way of offering a prayer that delivered the
goods. NOELS’s resurrection.
(This story is based largely on the life and
death of a real patient. He and I struggled for
years to avoid a killing and he chose suicide, I’m
certain, as his contribution to that struggle. A
new NOEL walked into my office last week)

NEWS

The 4th Congress of Asian Homoeopathic

Medical League shall be held at Colombo, Sri
Lanka, on 23, 24 and 25 November, 1991. The
subjects are:
1. Homoeopathic treatment for drug addiction.
2. Asthma, allergy and homoeopathic treatment.
3. Surgical diseases, cancers, tumours, etc. and
homoepathic treatment.
4. Renal calculi and gall stones and
homoeopathic treatment.
5. Research in homoeopathy carriedout by
CCRH, India.
6. AIDS and other viral diseases and
homoeopathic treatment.
7. Use of computer in homoeopathic practice.
8. Cure of skin diseases by homoeopathic
medicines without external application.
9. Free subjects.
Papers on these subjects may be sent to Dr.
M.A. Latiff, 23, Amaraswkera Mawatha,
Colombo 5, Sri Lanka, by 15.10’91. The